Interference of Khat with Treatment of Paranoid Schizophrenia

Objective: Khat is a habit forming substance widely used in Middle East countries and found to have huge societal and healthcare implications.This study was intended to estimate the possible interference of with antipsychotic medications and to investigate the frequency of relapse associated with concurrent use of anti depressants and khat. Methods: 69 Patients suffering from paranoid schizophrenia were involved in this study. The participants were classified according to their khat chewing habits into two categories; 1) Controls who did not chew khat during the treatment from acute episodes, and 2) Cases who chewed khat during treatment, during discharged for holidays or when shifted to outpatient facilities. Results: The results showed that usage the antidepressant fluoxetine in combination with either risperidone or haloperidol increased the tendency of relapse. Khat may interfere with either of the agents alone when used in large quantities, but there was less drug interaction than when fluoxetine was used. The use of depot neuroleptics and haloperidol with the appropriate dose adjustment appeared to reduce the tendency to relapse even though khat was used. Still such a risk of interaction cannot be avoided if khat is abused. Conclusion: Khat can be described as a substance of potential abuse in psychotic patients and may lead to the aggravation of psychotic conditions due to possible drug interaction with neuroleptics, which may reduce the effectiveness of such drugs and increase the frequency of relapse.