Evaluation of Single Versus Combination Antipsychotic Treatment and Clinical Outcomes

Signature Grand, Davie, Florida, USA

Background. The purpose of this evaluation was to determine if combination antipsychotic treatment (CAT) is superior to single antipsychotic treatment (SAT) in clinical outcomes as reflected by the Brief Psychiatric Rating Scale (BPRS), the Global Assessment of Functioning scale (GAF), and the Abnormal Involuntary Movement Scale (AIMS). Methods. This evaluation reviewed 329 active patient records in an inpatient psychiatric facility during December 2006. Data collected included: demographics; diagnoses; treatment regimens; adjunctive medications; BPRS, AIMS, and GAF scores. BPRS and AIMS scores were averaged and compared utilizing an unpaired, two-tailed t-test. GAF scores were obtained from admission records and at the time of this evaluation. Improvement within groups was evaluated via a paired, 2-tailed t-test. All confidence intervals were 0.95. Results. Three hundred ten patient records met inclusion criteria. Data showed statistically significant differences in mean BPRS-18 (34.90 vs. 36.36, n=305, p=0.02) and AIMS scores (1.53 vs. 0.68, n=268, p=0.01) among SAT versus CAT, respectively. Baseline GAF scores showed no significant difference (32.67 vs. 31.71, n=300, p=0.32) between SAT and CAT groups, respectively. Though both groups demonstrated improvement in GAF scores from baseline, no significant difference was found (34.91 vs. 34.91, n=300, p=1) between SAT and CAT groups, respectively, at the time of evaluation. Conclusion. Efficacy measures indicated statistical differences favoring SAT regimens over CAT regimens when groups were comparable at baseline. Interestingly, patients receiving CAT had significantly lower AIMS scores, suggesting no increase in occurrence of extrapyramidal symptoms. Further studies are required to clarify roles of these treatments in psychosis.