Aim: The chronic nature of schizophrenia usually demands uninterrupted treatment in order to
maintain optimal clinical and functional outcomes. It has been speculated that patients receiving
atypical antipsychotics may persist longer in treatment than those receiving typical antipsychotics
because of the lower risk of inducing extra-pyramidal symptoms. This study aimed to compare
treatment persistence among patients with schizophrenia receiving atypical versus typical
antipsychotics after discharge from a psychiatric hospital in Lagos, south-west Nigeria.
Study Design and Methodology: A retrospective cohort study design. Clinical records of 162
patients with schizophrenia admitted to a public psychiatric hospital were extracted to determine
their persistence with treatment over a period of one year after their discharge to out-patient clinic.
Treatment persistence (time to all cause treatment discontinuation) was determined using the
Kaplan-Meier Survival analyses. The log rank test compared persistence in treatment between
patients receiving atypical versus typical antipsychotic medications.
Results: Only 27.1% persisted in treatment for six months, while 19.1% persisted for one year.
The mean time to all cause treatment discontinuation was 17.3 (±1.5) weeks (95% C.I= 14.4-20.3).
The mean duration of treatment persistence for patients receiving typical antipsychotics was 16.7
(±2.7) weeks (95% C.I= 11.5-22.0), and 17.7 (±1.8) weeks (95% C.I= 14.2-21.2) for patients
receiving atypical antipsychotics. There was no significant difference in treatment persistence
between the two groups (p=0.762).
Conclusion: There is a poor rate of persistence in treatment among patients with schizophrenia,
regardless of the class of antipsychotics received. Considering the negative consequences of nonpersistence
in treatment including increased risk of relapse, re-hospitalisation and suicide, there is
a dire need for interventions to facilitate treatment persistence in schizophrenia