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  Česky / Czech version Čes. a slov. Psychiat., 99, 2003, No. 3, pp. 134 - 141.
 
Polypharmacotherapy – when is it Treatment of the First or Second Choice? Part I. 
Češková E., Kašpárek T. 

Psychiatrická klinika LF MU a FN Brno, přednosta prof. MUDr. E. Češková, CSc.
 


Summary:

       Data about treatment of schizoaffective and bipolar disorders are summarised. In both disorders the frequent first choice is the combination of mood stabilizers and antipsychotics, respective antidepressants. In the 70’s lithium was very popular, in the 80’s anticonvulsants appeared and in the 90’s atypical antipsychotics started to be in the focus of attention. It is not clear whether atypical antipsychotics are mood stabilizers, because there is a lack of adequete studies. The authors data about the treatment of schizoaffective disorders are presented. The authors, using retrospective chart analysis, found that in this indication antipsychotics were preferred. On admission mood stabilizers were used in 20/64 (31 %), only in 3/20 (15 %) as monotherapy and in combination, in 46/64 (72 %) antipsychotics were used. Atypical antipsychotics were preferred (33/46, 72 %) to conventional antipsychotics (21/46, 46 %). This ratio persisted on discharge. On discharge a higher number of patients were treated with antipsychotics (72 % vs 91 %), combinations of antipsychotics with mood stabilizers (26 % vs 40 %) and combinations of antipsychotics (13 % vs 22 %). The most widely used atypical antipsychotic on admission was risperidone (in 39 %), on discharge olanzapine (in 35 % of the total number of patients treated with atypical antipsychotics).

        Key words: polypharmacotherapy, schizoaffective disorder, bipolar disorder, combinations, with mood stabilizers, atypical antipsychotics.
       

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