Year: 2025 | Month: December | Volume: 15 | Issue: 12 | Pages: 40-49
DOI: https://doi.org/10.52403/ijhsr.20251205
Prescription Patterns of Antipsychotics in Schizophrenia: Influence of Symptom Predominance and Clinical Global Impression Scale
Namita Dash1, Indraja Sharma2, Anusuya Gehlot3, Rajkumar Rathore4, Ashok Seervi5
1Resident, Department of Pharmacology, 2Senior Resident, Department of Psychiatry, 3Senior Professor and HOD, Department of Pharmacology, 4Senior Professor, Department of Pharmacology, 5Assistant Professor, Department of Psychiatry
Dr SN Medical College, Rajasthan University of Health Sciences, Jodhpur, India.
Corresponding Author: Rekha Shaurya
ABSTRACT
Background: Antipsychotics are central to schizophrenia treatment, and prescribing decisions may be influenced by symptom predominance (positive vs. negative) and illness severity. This study aimed to evaluate antipsychotic prescribing patterns based on these clinical factors among patients with schizophrenia in a tertiary care setting.
Methods: A cross-sectional observational study was conducted among 100 adult outpatients diagnosed with schizophrenia at a tertiary care hospital in Western Rajasthan. Data were collected using a structured proforma, including demographic and clinical variables. Symptom predominance was determined clinically, and illness severity was assessed using the Clinical Global Impression-Schizophrenia (CGI-Sch) scale. Prescribing trends were analysed descriptively, and binary logistic regression was used to identify predictors of polypharmacy (≥2 antipsychotics).
Results: The mean age of participants was 42.6 ± 12.9 years, with males comprising 57%. Negative symptoms predominated in 68% of patients. The mean number of prescribed drugs was 4.14 ± 1.26, and the mean number of antipsychotics was 1.67 ± 0.75. Atypical antipsychotics were used in 74% of patients. Polypharmacy was more common in those with CGI scores ≥12 (aOR 3.30, 95% CI: 1.42–7.7, p = 0.0056), while symptom type did not significantly influence prescribing patterns. Female gender was associated with lower odds of receiving multiple antipsychotics.
Conclusion: Illness severity, rather than symptom predominance, was significantly associated with antipsychotic polypharmacy. These findings highlight the need for individualized, severity-based prescribing practices in schizophrenia care.
Key words: Antipsychotics, Schizophrenia, Prescribing pattern