Poster
102
(#102) Longitudinal Trends in Antipsychotic Polypharmacy and Associated Outcomes in Schizophrenia
Psych Congress 2025
Abstract: Background: For over 70 years, pharmacologic treatment of schizophrenia has relied on D2 dopamine receptor antagonists, largely confining treatment strategies to switching or combining these agents to manage symptoms.
Methods: This study analyzed adults with schizophrenia initiating antipsychotic treatment between 01/01/2018-12/31/2024 identified in the IQVIA PharMetrics® Plus database. Index date was first antipsychotic claim after 01/01/2018, preceded by a 12-month antipsychotic-free baseline period. The utilization patterns of antipsychotic monotherapy and polytherapy, along with associated outcomes and changes over time, were evaluated. Polytherapy episodes were defined as the concurrent use of ≥2 antipsychotics for ≥90 days, allowing for a 32-day gap.
Results: 6830 patients met study criteria (63.1% male, mean±SD age: 42.8±16.7 years). During the baseline period, patients had an average of 0.94 hospitalizations, 2.68 emergency admissions, and 20.59 outpatient visits. After the index date, proportion of patients treated with ≥1 polytherapy episode increased from 8.3% by year 1 to 20.0% by year 5; average polytherapy duration increased from 229.1±107.5 days to 640.1±570.1 days. The proportion of patients with hypertension, dyslipidemia, obesity, sleep-wake disorders, and type 2 diabetes increased during the follow-up. Most commonly used polytherapy approaches were multiple oral second-generation (41.7%), oral plus LAI second-generation (29.6%), and oral first- plus second-generation antipsychotics (18.8%). The most commonly prescribed monotherapies were oral second-generation antipsychotics (76.0%), short-acting injectable first-generation antipsychotics (21.5%), and long-acting injectable second-generation antipsychotics (21.4%).
Conclusion: The increasing incidence and duration of polypharmacy over the illness course highlight the need to reconsider current treatment approaches as new options emerge
Short Description: Short description: An analysis of the IQVIA PharMetrics® Plus database examined adults with schizophrenia and ≥1 antipsychotic medication claim. Results revealed substantial illness burden at baseline, characterized by frequent healthcare utilization and psychotropic medication use. The incidence and duration of antipsychotic polytherapy, as well as antipsychotic-related adverse events, increased notably during follow-up, highlighting a need to reassess existing treatment paradigms, particularly as a new therapeutic option utilizing a novel mechanism of action is now available.
Name of Sponsoring Organization(s): Bristol Myers Squibb
Methods: This study analyzed adults with schizophrenia initiating antipsychotic treatment between 01/01/2018-12/31/2024 identified in the IQVIA PharMetrics® Plus database. Index date was first antipsychotic claim after 01/01/2018, preceded by a 12-month antipsychotic-free baseline period. The utilization patterns of antipsychotic monotherapy and polytherapy, along with associated outcomes and changes over time, were evaluated. Polytherapy episodes were defined as the concurrent use of ≥2 antipsychotics for ≥90 days, allowing for a 32-day gap.
Results: 6830 patients met study criteria (63.1% male, mean±SD age: 42.8±16.7 years). During the baseline period, patients had an average of 0.94 hospitalizations, 2.68 emergency admissions, and 20.59 outpatient visits. After the index date, proportion of patients treated with ≥1 polytherapy episode increased from 8.3% by year 1 to 20.0% by year 5; average polytherapy duration increased from 229.1±107.5 days to 640.1±570.1 days. The proportion of patients with hypertension, dyslipidemia, obesity, sleep-wake disorders, and type 2 diabetes increased during the follow-up. Most commonly used polytherapy approaches were multiple oral second-generation (41.7%), oral plus LAI second-generation (29.6%), and oral first- plus second-generation antipsychotics (18.8%). The most commonly prescribed monotherapies were oral second-generation antipsychotics (76.0%), short-acting injectable first-generation antipsychotics (21.5%), and long-acting injectable second-generation antipsychotics (21.4%).
Conclusion: The increasing incidence and duration of polypharmacy over the illness course highlight the need to reconsider current treatment approaches as new options emerge
Short Description: Short description: An analysis of the IQVIA PharMetrics® Plus database examined adults with schizophrenia and ≥1 antipsychotic medication claim. Results revealed substantial illness burden at baseline, characterized by frequent healthcare utilization and psychotropic medication use. The incidence and duration of antipsychotic polytherapy, as well as antipsychotic-related adverse events, increased notably during follow-up, highlighting a need to reassess existing treatment paradigms, particularly as a new therapeutic option utilizing a novel mechanism of action is now available.
Name of Sponsoring Organization(s): Bristol Myers Squibb
