Yu-Tao Xiang and Quan-Sheng Tang contributed equally to the paper.
Common use of high doses of antipsychotic medications in older Asian patients with schizophrenia (2001–2009)
Version of Record online: 13 AUG 2013
Copyright © 2013 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry
Volume 29, Issue 4, pages 359–366, April 2014
How to Cite
Xiang, Y.-T., Li, Y., Correll, C. U., Ungvari, G. S., Chiu, H. F.K., Lai, K. Y. C., Tang, Q.-S., Hao, W., Si, T.-M., Wang, C.-Y., Lee, E. H. M., He, Y.-L., Yang, S.-Y., Chong, M.-Y., Kua, E.-H., Fujii, S., Sim, K., Yong, M. K.H., Trivedi, J. K., Chung, E.-K., Udomratn, P., Chee, K.-Y., Sartorius, N., Tan, C.-H. and Shinfuku, N. (2014), Common use of high doses of antipsychotic medications in older Asian patients with schizophrenia (2001–2009). Int. J. Geriat. Psychiatry, 29: 359–366. doi: 10.1002/gps.4011
- Issue online: 6 MAR 2014
- Version of Record online: 13 AUG 2013
- Manuscript Accepted: 17 JUL 2013
- Manuscript Revised: 30 JUN 2013
- Manuscript Received: 27 JAN 2013
- Feinstein Institute for Medical Research
- National Institute of Mental Health (NIMH)
- National Alliance for Research in Schizophrenia and Depression (NARSAD)
- prescription patterns;
- high dose;
- older patients;
This study aimed to examine the use of high doses of antipsychotic medications (≥600 mg/day chlorpromazine equivalent) in older Asian patients with schizophrenia and its demographic and clinical correlates.
Information on hospitalized patients with schizophrenia aged ≥50 years was extracted from the database of the Research on Asian Psychotropic Prescription Patterns study (2001–2009). Data on 2203 patients in six Asian countries and territories, including China, Hong Kong, Japan, Korea, Singapore and Taiwan, were analyzed. Socio-demographic and clinical characteristics and antipsychotic prescriptions were recorded.
The frequency for high-dose antipsychotic medications was 36.0% overall, with 38.4% in 2001, 33.3% in 2004 and 36.0% in 2009. Multiple logistic regression analysis of the whole sample showed that compared to patients receiving low-medium antipsychotic doses, those on high doses had a longer illness duration (odds ratio (OR): 2.0, 95% confidence interval (CI):1.2–3.3, p = 0.008), were more likely in the 50–59-year group (OR: 0.95, 95% CI: 0.94–0.97, p < 0.001), more often had current positive (OR: 1.5, 95% CI: 1.2–1.8, p < 0.001) or negative symptoms (OR: 1.3, 95% CI: 1.03–1.6, p = 0.03), and more commonly received antipsychotic polypharmacy (OR: 5.3, 95% CI: 4.1–6.7, p < 0.001). Extrapyramidal symptoms (p = 0.25) and tardive dyskinesia (p = 0.92) were not more frequent in the high-dose group.
High doses of antipsychotic medications were used in more than one third of older Asian patients with schizophrenia. The reasons for the frequent use of high antipsychotic doses in older Asian patients warrant further investigation. Copyright © 2013 John Wiley & Sons, Ltd.