{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:26:35Z","timestamp":1753892795033,"version":"3.41.2"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T00:00:00Z","timestamp":1649289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010661","name":"Horizon 2020 Framework Programme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Maintenance therapy of patients with primary psychosis spectrum disorders (PSD) in the Western Balkans has received limited interest so far. The present study aimed to investigate long-term prescription patterns among outpatients with PSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Information about prescription of antipsychotics (AP), benzodiazepines (BZD) and other psychotropic medication over a 6-month period was collected from outpatients (<jats:italic>n<\/jats:italic> = 134; ICD-10 diagnosis F20-29) recruited by a larger multi-site study, to find mean daily number of psychotropic drugs, AP prescription patterns (including AP daily dose, route of administration, monotherapy <jats:italic>vs<\/jats:italic>. polypharmacy) and BZD utilization (long-term add-on BZD therapy). Additionally, sex-differences in the variables were explored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clinically stable outpatients (age 41.7 \u00b1 11.0; male 62.7%; duration of untreated illness 12.7 \u00b1 8.7 years; mean number of lifetime hospitalizations 2.6 \u00b1 0.7) were prescribed 2.8 \u00b1 1.1 psychotropic medications daily. The mean 6-month AP dose was 14.2 \u00b1 7.8 mg olanzapine equivalents. Long-acting injectable AP was prescribed to 25.2% of the patients. Long-term AP monotherapy was found in 52.7% patients and most of them were prescribed second generation AP (65.2%). Long-term AP polypharmacy (42.7%) was more common in males (<jats:italic>p<\/jats:italic> = 0.015). The most frequent co-prescription patterns were first generation AP plus clozapine. The highest rate of long-term AP co-prescription was found for BZD (in 42.7% cases, average 6-months daily dose of 2.8 \u00b1 2.7 mg lorazepam equivalents) and anticholinergics (33.6%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Existing appropriately designed interventions aiming to safely switch the inappropriate therapeutic regimens, i.e. very high prevalence of long-term AP polypharmacy and non-rational BZD co-prescription, should be implemented in the region of Western Balkans.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2022.796719","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T06:09:57Z","timestamp":1649311797000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Maintenance Therapy of Psychosis Spectrum Disorders in a Real-World Setting: Antipsychotics Prescription Patterns and Long-Term Benzodiazepine Use"],"prefix":"10.3389","volume":"13","author":[{"given":"Nadja P.","family":"Maric","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanja","family":"Andric Petrovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"Russo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Jerotic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Ristic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bojana","family":"Savi\u0107","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara","family":"Pemovska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milos","family":"Milutinovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emina","family":"Ribic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvana","family":"Markovska-Simoska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alma","family":"Dzubur Kulenovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolina","family":"Jovanovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1002\/wps.20516","article-title":"What is the risk-benefit ratio of long-term antipsychotic treatment in people with schizophrenia","volume":"17","author":"Correll","year":"2018","journal-title":"World.Psychiatry"},{"key":"B2","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.schres.2019.09.013","article-title":"Antipsychotic treatment in the maintenance phase of schizophrenia: An updated systematic review of the guidelines and algorithms","volume":"215","author":"Shimomura","year":"2020","journal-title":"Schizophr Res."},{"key":"B3","doi-asserted-by":"crossref","DOI":"10.3109\/15622975.2012.739708","article-title":"World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia,part 2: update 2012 on the long-term treatment of schizophrenia and management of antipsychotic-induced side effects","volume-title":"World J Biol Psychiatry","author":"Hasan","year":"2013"},{"key":"B4","unstructured":"Nacionalni vodi\u010d dobre klini\u010dke prakse za dijagnostikovanje i le\u010denje shizofrenije2013"},{"key":"B5","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1023\/A:1022369323451","article-title":"Patient, provider, and treatment factors associated with poor-quality care for schizophrenia","volume":"1","author":"Young","year":"1999","journal-title":"Ment Health Serv Res"},{"key":"B6","doi-asserted-by":"publisher","first-page":"650904","DOI":"10.3389\/fpsyt.2021.650904","article-title":"The pharmacodynamics of antipsychotic drugs in women and men","volume":"12","author":"Seeman","year":"2021","journal-title":"Front Psychiatry."},{"key":"B7","doi-asserted-by":"crossref","DOI":"10.5498\/wjp.v8.i5.125","article-title":"Women who suffer from schizophrenia: Critical issues","volume-title":"World. 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