Ntimani, Marcia Tsakani2025-03-242022-06Ntimani, Marcia Tsakani. (2022). A comparison of anticholinergic use by schizophrenic patients on polypharmacy and those receiving monotherapy. [Masters dissertation, University of the Witwatersrand, Johannesburg]. WIReDSpace. https://hdl.handle.net/10539/44420https://hdl.handle.net/10539/44420A research report submitted in partial fulfilment of requirements for the degree of Master of Medicine in the branch of psychiatry, to the Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, 2022.Introduction: Schizophrenia is one of the most debilitating mental disorders globally and one of the most challenging illnesses to treat. Although guidelines consistently caution against antipsychotic polypharmacy (APP) in clinical practice, their prescription rate is still significant and leads to a greater side-effect burden in patients. Therefore, this study aimed to document the prevalence of APP-related anticholinergic use compared to monotherapy in patients with schizophrenia in the community psychiatric clinics in Soweto, Johannesburg. Methods: A retrospective record review was conducted. Data from clinical files of patients (18 years and above) diagnosed with schizophrenia attending four clinics in Soweto in September was analysed. Information such as age, gender, presence of extrapyramidal side-effects (EPSEs), comorbid conditions, and current treatment records was collected. Logistic regression assessed the association between APP, anticholinergic use, and sociodemographic and clinical characteristics. Results: One hundred files that met the inclusion criteria were reviewed. The study population consisted mainly of males (n=73, 73%), with an average age of 47.6 years and an average illness duration of 18.5 years. Of the 100 selected patients with schizophrenia, 35% were on APP, and 57.7% of those were prescribed an anticholinergic agent. Of the patients on anticholinergic agents, 92% had a prescription for a single first-generation antipsychotic (FGA) or an FGA in combination with a second-generation antipsychotic (SGA). The most prescribed antipsychotics were risperidone and flupenthixol decanoate, either as monotherapy or combined. Conclusion: The findings in this study correlated with the existing literature. Anticholinergic prescription rates are still high and associated with APP, male gender, and the use of FGAs.en©2022 University of the Witwatersrand, Johannesburg. All rights reserved. The copyright in this work vests in the University of the Witwatersrand, Johannesburg. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of University of the Witwatersrand, Johannesburg.SchizophreniaAntipsychotic polypharmacy (APP)Community psychiatric clinics in SowetoJohannesburgMEDICINE::PsychiatryExtrapyramidal side-effects (EPSEs)First-generation antipsychotic (FGA)Second-generation antipsychotic (SGA)UCTDDissertationUniversity of the Witwatersrand, JohannesburgSDG-3: Good health and well-beingSDG-4: Quality education