Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-18T06:45:57.276Z Has data issue: false hasContentIssue false
  • English
  • Français

Prescribing patterns of low doses of antipsychotic medications in older Asian patients with schizophrenia, 2001–2009

Published online by Cambridge University Press:  03 February 2012

Yu-Tao Xiang ,
Faith Dickerson ,
Julie Kreyenbuhl ,
Gabor S. Ungvari ,
Chuan-Yue Wang ,
Tian-Mei Si ,
Edwin H. M. Lee ,
Yan-Ling He ,
Helen F. K. Chiu  and
Kelly Y. C. Lai
...Show all authors
Yu-Tao Xiang*
Affiliation:
Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China Beijing Anding Hospital, Capital Medical University, Beijing, China
Faith Dickerson
Affiliation:
The Stanley Research Program at Sheppard Pratt, Baltimore, Maryland, USA
Julie Kreyenbuhl
Affiliation:
Division of Services Research, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA Veterans Administration Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, Maryland, USA
Gabor S. Ungvari
Affiliation:
The University of Notre Dame Australia/Marian Centre, Perth, Australia
Chuan-Yue Wang
Affiliation:
Beijing Anding Hospital, Capital Medical University, Beijing, China
Tian-Mei Si*
Affiliation:
Key Laboratory of Mental Health, Ministry of Mental Health & Peking University Institute of Mental Health, Beijing, China
Edwin H. M. Lee
Affiliation:
Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
Yan-Ling He
Affiliation:
Shanghai Mental Health Center, Shanghai, China
Helen F. K. Chiu
Affiliation:
Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
Kelly Y. C. Lai
Affiliation:
Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
Naotaka Shinfuku
Affiliation:
School of Human Sciences, Seinan Gakuin University Fukuoka, Japan
Shu-Yu Yang
Affiliation:
Taipei City Hospital, Taipei, Taiwan
Mian-Yoon Chong
Affiliation:
Kaohsiung Chang Gung Memorial Hospital and School of Medicine, Chang Gung University, Taiwan
Ee-Heok Kua
Affiliation:
National University of Singapore, Singapore
Senta Fujii
Affiliation:
Hyogo Institute for Traumatic Stress (HITS), Kobe, Japan
Kang Sim
Affiliation:
Institute of Mental Health, Buangkok View, Singapore
Michael K. H. Yong
Affiliation:
Institute of Mental Health, Buangkok View, Singapore
Jitendra K. Trivedi
Affiliation:
Department of Psychiatry, C.S.M. Medical University, Lucknow, Uttar Pradesh, India
Eun-Kee Chung
Affiliation:
National Seoul Hospital, Seoul, Korea
Pichet Udomratn
Affiliation:
Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Kok-Yoon Chee
Affiliation:
Department of Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neuroscience, Kuala Lumpur Hospital, Malaysia
Norman Sartorius
Affiliation:
Association for the Improvement of Mental Health Programs, Geneva, Switzerland
Chay-Hoon Tan
Affiliation:
National University of Singapore, Singapore
*
Correspondence should be addressed to: Dr. Yu-Tao Xiang, Department of Psychiatry, Chinese University of Hong Kong, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, N.T., Hong Kong. Phone: +852-2607-6041; Fax: +852-2647-5321. Email: [email protected].
Dr. Tian-Mei Si, Peking University Institute of Mental Health, Beijing, China. Email: [email protected].
Get access

Abstract

Background: This study examined the use of low doses of antipsychotic medications (300 mg/day CPZeq or less) in older Asian patients with schizophrenia and its demographic and clinical correlates.

Methods: Information on hospitalized patients with schizophrenia, aged 55 years or older, was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study (2001–2009). Data on 1,452 patients in eight Asian countries and territories including China, Hong Kong, Japan, Korea, Singapore, Taiwan, India, and Malaysia were analyzed. Sociodemographic and clinical characteristics and antipsychotic prescriptions were recorded using a standardized protocol and data collection procedure.

Results: The prescription frequency for low doses of antipsychotic medications was 40.9% in the pooled sample. Multiple logistic regression analysis of the whole sample showed that patients on low doses of antipsychotic medications were more likely to be female, have an older age, a shorter length of illness, and less positive symptoms. Of patients in the six countries and territories that participated in all the surveys between 2001 and 2009, those in Japan were less likely to receive low doses of antipsychotics.

Conclusion: Low doses of antipsychotic medications were only applied in less than half of older Asian patients with schizophrenia.

Keywords

schizophreniaprescription patternslow dosesolder patientsAsia
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 6 , June 2012 , pp. 1002 - 1008
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexopoulos, G. S., Streim, J., Carpenter, D. and Docherty, J. P. (2004). Using antipsychotic agents in older patients. Journal of Clinical Psychiatry, 65 (Suppl. 2), 5–99; discussion 100–102; quiz 103–104.Google ScholarPubMed
APA (1997). Practice Guideline for the Treatment of Patients with Schizophrenia. Washington, DC: American Psychiatric Press.Google Scholar
Barbui, C. et al. (2006). Persistence with polypharmacy and excessive dosing in patients with schizophrenia treated in four European countries. International Clinical Psychopharmacology, 21, 355–362.CrossRefGoogle ScholarPubMed
Chiu, H. F., Shum, P. S. and Lam, C. W. (1991). Psychotropic drug prescribing to chronic schizophrenics in a Hong Kong hospital. International Journal of Social Psychiatry, 37, 187–191.CrossRefGoogle Scholar
Chong, M. Y. et al. (2004). Antipsychotic drug prescription for schizophrenia in East Asia: rationale for change. Psychiatry and Clinical Neurosciences, 58, 61–67.CrossRefGoogle ScholarPubMed
Chow, L. Y., Ungvari, G. S., Chiu, H. F. K. and Leung, T. (1999). Psychotropic drug prescription for chronic psychiatric pateints in a long-stay care facility. Hong Kong Journal of Psychiatry, 9, 15–20.Google Scholar
Frackiewicz, E. J., Sramek, J. J., Herrera, J. M., Kurtz, N. M. and Cutler, N. R. (1997). Ethnicity and antipsychotic response. Annals of Pharmacotherapy, 31, 1360–1369.CrossRefGoogle ScholarPubMed
Ji, Z. F. (2005). Evaluation and analysis of drug-use in hospitals of China. Evaluation of Clinical Usage of Partial Dopamine Receptor Agonist, 5, 89–91 [in Chinese].Google Scholar
Kane, J. M. et al. (1998). Guidelines for depot antipsychotic treatment in schizophrenia. European neuropsychopharmacology consensus conference in Siena, Italy. European Neuropsychopharmacology, 8, 55–66.CrossRefGoogle ScholarPubMed
Kohen, I., Lester, P. E. and Lam, S. (2010). Antipsychotic treatments for the elderly: efficacy and safety of aripiprazole. Neuropsychiatric Disease and Treatment, 6, 47–58.CrossRefGoogle ScholarPubMed
Kreyenbuhl, J., Buchanan, R. W., Dickerson, F. B. and Dixon, L. B. (2010). The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2009. Schizophrenia Bulletin, 36, 94–103.CrossRefGoogle ScholarPubMed
Lehman, A. F. et al. (2004). The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2003. Schizophrenia Bulletin, 30, 193–217.CrossRefGoogle ScholarPubMed
Masand, P. S. (2000). Side effects of antipsychotics in the elderly. Journal of Clinical Psychiatry, 61 (Suppl. 8), 43–49.Google ScholarPubMed
Meyers, B. S. and Jeste, D. V. (2010). Geriatric psychopharmacology: evolution of a discipline. Journal of Clinical Psychiatry, 71, 1416–1424.CrossRefGoogle ScholarPubMed
Okuma, T. (1981). Differential sensitivity to the effects of psychotropic drugs: psychotics vs normals; Asian vs Western populations. Folia Psychiatrica et Neurologica Japonica, 35, 79–87.Google Scholar
Seeman, M. V. (2010). Schizophrenia: women bear a disproportionate toll of antipsychotic side effects. Journal of the American Psychiatric Nurses Association, 16, 21–29.CrossRefGoogle Scholar
Shinfuku, N. and Tan, C. H. (2008). Pharmacotherapy for schizophrenic inpatients in East Asia – changes and challenges. International Review of Psychiatry, 20, 460–468.CrossRefGoogle ScholarPubMed
Sim, K. et al. (2004). Antipsychotic polypharmacy in patients with schizophrenia: a multicentre comparative study in East Asia. British Journal of Clinical Pharmacology, 58, 178–183.CrossRefGoogle ScholarPubMed
Sim, K. et al. (2009). Low doses of antipsychotic drugs for hospitalized schizophrenia patients in East Asia: 2004 vs. 2001. International Journal of Neuropsychopharmacology, 12, 117–123.CrossRefGoogle ScholarPubMed
Uchida, H., Mamo, D. C., Mulsant, B. H., Pollock, B. G. and Kapur, S. (2009a). Increased antipsychotic sensitivity in elderly patients: evidence and mechanisms. Journal of Clinical Psychiatry, 70, 397–405.CrossRefGoogle ScholarPubMed
Uchida, H., Pollock, B. G., Bies, R. R. and Mamo, D. C. (2009b). Predicting age-specific dosing of antipsychotics. Clinical Pharmacology and Therapeutics, 86, 360–362.CrossRefGoogle ScholarPubMed
Ungvari, G. S., Chung, Y. G., Chee, Y. K., Fung-Shing, N., Kwong, T. W. and Chiu, H. F. (2002). The pharmacological treatment of schizophrenia in Chinese patients: a comparison of prescription patterns between 1996 and 1999. British Journal of Clinical Pharmacology, 54, 437–444.CrossRefGoogle ScholarPubMed
Woods, S. W. (2003). Chlorpromazine equivalent doses for the newer atypical antipsychotics. Journal of Clinical Psychiatry, 64, 663–667.CrossRefGoogle ScholarPubMed