Abstract：
OBJECTIVE: Prison settings have limited resources, and it is of particular interest to analyze which antipsychotics are commonly prescribed in these conditions and to determine the prevalence of the adverse effects.
METHODS: A cross-sectional, epidemiological survey was used to measure the prevalence of antipsychotic prescribing among adult prisoners in Sremska Mitrovica Prison in 2020.
RESULTS: The prevalence of antipsychotic use was 7.58%. The most commonly prescribed antipsychotic was clozapine (45.36%), but also olanzapine, haloperidol and risperidone were prescribed. The incidence of extrapyramidal adverse effects was nonexistent and the metabolic parameters did not differ between participants using metabolic syndrome-inducing antipsychotics and those who were prescribed metabolically inert medications. The prescribed doses were lower compared with the recommended.
CONCLUSIONS: This research includes certain points that should be cautiously considered. First, the data were cross-sectional and the findings did not provide causal interpretations. Second, the data are from a single penitentiary institution, albeit the largest in the country; however, that may affect the generalizability of the findings. Third, because the included subjects were not hospitalized, some laboratory analyses were not available, according to the local regulations, and thus the prevalence of metabolic syndrome could not be precisely determined.
CONCLUSIONS: The prevalence of the antipsychotic use in prison environment is significantly higher than in general population. The most frequently prescribed antipsychotics are clozapine and olanzapine. The prevalence of adverse effects is rare, however, that is possibly due to low doses of the prescribed antipsychotics. The list of therapeutic options available to the incarcerated persons in this facility is also limited. The list of available antipsychotics does not include some atypical antipsychotics with more favorable safety and tolerability profile, such as aripiprazole or cariprazine. Long-acting antipsychotic injectables were also not available to these patients. Laboratory analyses are not regularly conducted and do not include some essential parameters such as lipid status or differential blood count. Low-dose antipsychotics for behavioral symptoms appears to be well tolerated under prison conditions where adherence is assured. It is effective during the prison stay but long-term effects, especially after release from prison, had not been studied.
CONCLUSIONS: This paper advocates for better quality of health care in this correctional facility: more therapeutic options and better laboratory monitoring. The authors justify the use of clozapine in this settings due its benefits in reducing violence and aggression; however, further research would be necessary to clarify does the use of clozapine in incarcerated persons cause behavioral improvements that could result in shorter incarcerations, less recidivism and better quality of life.
CONCLUSIONS: To the best of the authors\' knowledge, this is the first insight of the antipsychotic prescribing practice in Serbia. There is very limited data on prisoners\' health care, especially mental health care, in Balkan countries. The antipsychotic prescribing pattern in this sample is characterized with higher than expected clozapine use, but without expected adverse effects.
METHODS: A cross-sectional, epidemiological survey was used to measure the prevalence of antipsychotic prescribing among adult prisoners in Sremska Mitrovica Prison in 2020.
RESULTS: The prevalence of antipsychotic use was 7.58%. The most commonly prescribed antipsychotic was clozapine (45.36%), but also olanzapine, haloperidol and risperidone were prescribed. The incidence of extrapyramidal adverse effects was nonexistent and the metabolic parameters did not differ between participants using metabolic syndrome-inducing antipsychotics and those who were prescribed metabolically inert medications. The prescribed doses were lower compared with the recommended.
CONCLUSIONS: This research includes certain points that should be cautiously considered. First, the data were cross-sectional and the findings did not provide causal interpretations. Second, the data are from a single penitentiary institution, albeit the largest in the country; however, that may affect the generalizability of the findings. Third, because the included subjects were not hospitalized, some laboratory analyses were not available, according to the local regulations, and thus the prevalence of metabolic syndrome could not be precisely determined.
CONCLUSIONS: The prevalence of the antipsychotic use in prison environment is significantly higher than in general population. The most frequently prescribed antipsychotics are clozapine and olanzapine. The prevalence of adverse effects is rare, however, that is possibly due to low doses of the prescribed antipsychotics. The list of therapeutic options available to the incarcerated persons in this facility is also limited. The list of available antipsychotics does not include some atypical antipsychotics with more favorable safety and tolerability profile, such as aripiprazole or cariprazine. Long-acting antipsychotic injectables were also not available to these patients. Laboratory analyses are not regularly conducted and do not include some essential parameters such as lipid status or differential blood count. Low-dose antipsychotics for behavioral symptoms appears to be well tolerated under prison conditions where adherence is assured. It is effective during the prison stay but long-term effects, especially after release from prison, had not been studied.
CONCLUSIONS: This paper advocates for better quality of health care in this correctional facility: more therapeutic options and better laboratory monitoring. The authors justify the use of clozapine in this settings due its benefits in reducing violence and aggression; however, further research would be necessary to clarify does the use of clozapine in incarcerated persons cause behavioral improvements that could result in shorter incarcerations, less recidivism and better quality of life.
CONCLUSIONS: To the best of the authors\' knowledge, this is the first insight of the antipsychotic prescribing practice in Serbia. There is very limited data on prisoners\' health care, especially mental health care, in Balkan countries. The antipsychotic prescribing pattern in this sample is characterized with higher than expected clozapine use, but without expected adverse effects.
摘要：
目标：监狱环境资源有限，分析在这些情况下常用的抗精神病药，并确定不良反应的发生率，是特别有意义的。
方法：横截面，流行病学调查用于测量2020年SremskaMitrovica监狱成年囚犯中抗精神病药处方的患病率。
结果：使用抗精神病药的患病率为7.58%。最常用的抗精神病药是氯氮平（45.36％），还有奥氮平,氟哌啶醇和利培酮被处方。锥体外系不良反应的发生率不存在，使用代谢综合征诱导的抗精神病药物的参与者和使用代谢惰性药物的参与者之间的代谢参数没有差异。处方剂量低于推荐剂量。
结论：这项研究包括了某些应该谨慎考虑的观点。首先,数据是横断面的,研究结果没有提供因果解释.第二,数据来自一个监狱机构，尽管是全国最大的；然而，这可能会影响调查结果的普遍性。第三，因为纳入的受试者没有住院，一些实验室分析不可用，根据当地规定，因此代谢综合征的患病率无法精确确定.
结论：监狱环境中使用抗精神病药的患病率明显高于普通人群。最常用的抗精神病药是氯氮平和奥氮平。不良反应的流行很少，然而,这可能是由于处方抗精神病药剂量低。该设施中被监禁者可用的治疗选择清单也有限。可用的抗精神病药物列表不包括一些具有更有利的安全性和耐受性的非典型抗精神病药物。如阿立哌唑或卡利拉嗪。这些患者也无法使用长效抗精神病药物注射剂。实验室分析不经常进行，不包括一些基本参数，如脂质状态或分类血细胞计数。在确保坚持的监狱条件下，用于行为症状的低剂量抗精神病药似乎可以很好地耐受。它在监狱期间有效，但长期影响，尤其是出狱后,没有被研究过。
结论：本文主张在这个惩教机构中提高医疗保健质量：更多的治疗选择和更好的实验室监测。作者证明在这种情况下使用氯氮平是合理的，因为它有利于减少暴力和侵略；然而，需要进一步的研究来澄清在被监禁的人中使用氯氮平是否会导致行为改善，从而导致更短的监禁，更少的累犯和更好的生活质量。
结论：据作者所知，这是对塞尔维亚抗精神病药处方实践的首次见解.关于囚犯保健的数据非常有限，尤其是精神保健,巴尔干国家该样本中的抗精神病药处方模式的特点是氯氮平的使用量高于预期，但没有预期的不利影响。
方法：横截面，流行病学调查用于测量2020年SremskaMitrovica监狱成年囚犯中抗精神病药处方的患病率。
结果：使用抗精神病药的患病率为7.58%。最常用的抗精神病药是氯氮平（45.36％），还有奥氮平,氟哌啶醇和利培酮被处方。锥体外系不良反应的发生率不存在，使用代谢综合征诱导的抗精神病药物的参与者和使用代谢惰性药物的参与者之间的代谢参数没有差异。处方剂量低于推荐剂量。
结论：这项研究包括了某些应该谨慎考虑的观点。首先,数据是横断面的,研究结果没有提供因果解释.第二,数据来自一个监狱机构，尽管是全国最大的；然而，这可能会影响调查结果的普遍性。第三，因为纳入的受试者没有住院，一些实验室分析不可用，根据当地规定，因此代谢综合征的患病率无法精确确定.
结论：监狱环境中使用抗精神病药的患病率明显高于普通人群。最常用的抗精神病药是氯氮平和奥氮平。不良反应的流行很少，然而,这可能是由于处方抗精神病药剂量低。该设施中被监禁者可用的治疗选择清单也有限。可用的抗精神病药物列表不包括一些具有更有利的安全性和耐受性的非典型抗精神病药物。如阿立哌唑或卡利拉嗪。这些患者也无法使用长效抗精神病药物注射剂。实验室分析不经常进行，不包括一些基本参数，如脂质状态或分类血细胞计数。在确保坚持的监狱条件下，用于行为症状的低剂量抗精神病药似乎可以很好地耐受。它在监狱期间有效，但长期影响，尤其是出狱后,没有被研究过。
结论：本文主张在这个惩教机构中提高医疗保健质量：更多的治疗选择和更好的实验室监测。作者证明在这种情况下使用氯氮平是合理的，因为它有利于减少暴力和侵略；然而，需要进一步的研究来澄清在被监禁的人中使用氯氮平是否会导致行为改善，从而导致更短的监禁，更少的累犯和更好的生活质量。
结论：据作者所知，这是对塞尔维亚抗精神病药处方实践的首次见解.关于囚犯保健的数据非常有限，尤其是精神保健,巴尔干国家该样本中的抗精神病药处方模式的特点是氯氮平的使用量高于预期，但没有预期的不利影响。
