TY - JOUR
T1 - Characteristics of discharge prescriptions for patients with schizophrenia or major depressive disorder
T2 - Real-world evidence from the Effectiveness of Guidelines for Dissemination and Education (EGUIDE) psychiatric treatment project
AU - Hashimoto, Naoki
AU - Yasui-Furukori, Norio
AU - Hasegawa, Naomi
AU - Ishikawa, Shuhei
AU - Numata, Shusuke
AU - Hori, Hikaru
AU - Iida, Hitoshi
AU - Ichihashi, Kayo
AU - Furihata, Ryuji
AU - Murata, Atsunobu
AU - Tsuboi, Takashi
AU - Takeshima, Masahiro
AU - Kyou, Yoshitaka
AU - Komatsu, Hiroshi
AU - Kubota, Chika
AU - Ochi, Shinichiro
AU - Takaesu, Yoshikazu
AU - Usami, Masahide
AU - Nagasawa, Tatsuya
AU - Hishimoto, Akitoyo
AU - Miura, Kenichiro
AU - Matsumoto, Junya
AU - Ohi, Kazutaka
AU - Yamada, Hisashi
AU - Inada, Ken
AU - Watanabe, Koichiro
AU - Shimoda, Kazutaka
AU - Hashimoto, Ryota
N1 - Funding Information:
This study was supported by the Japan Agency for Medical Research and Development (AMED) under Grant Number JP16dk0307060 , and AMED under Grant Number JP19dk0307083 , the Health and Labor Sciences Research Grants (H29‐Seishin‐Ippan‐001, 19GC1201), the Japanese Society of Neuropsychopharmacology , the Japanese Society of Mood Disorders and the Japanese Society of Clinical Neuropsychopharmacology . The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2021 The Author(s)
PY - 2021/9
Y1 - 2021/9
N2 - Background: Monopharmacy with antipsychotics and antidepressants is the first-line treatment for schizophrenia and major depressive disorder (MDD) in most clinical guidelines, while polypharmacy with psychotropic agents in the treatment of schizophrenia is common in clinical practice. There are no detailed data on the prescription patterns for inpatients with mental illness with reliable diagnoses made by treating psychiatrists. Methods: We gathered prescription data at discharge from 2177 patients with schizophrenia and 1238 patients with MDD from October 2016 to March 2018. Results: The patients with schizophrenia aged between 60 and 79 were prescribed lower doses of antipsychotics and hypnotics/anxiolytics than those aged between 40 and 59. There were significant differences between the prescription rate of antipsychotics in the patients with schizophrenia and that of antidepressants in the patients with MDD. The frequency of concomitant drugs such as anti-Parkinson drugs, anxiolytics/hypnotics and mood stabilizers in the subjects with schizophrenia prescribed antipsychotic polypharmacy was significantly higher than that with monotherapy. For the patients with schizophrenia, olanzapine, risperidone, aripiprazole, quetiapine, and blonanserin were the five most prescribed antipsychotics. For the patients with MDD, mirtazapine, duloxetine, escitalopram, trazodone and sertraline were the five most prescribed antidepressants. Conclusions: Our results showed the use of high doses of antipsychotics, high percentages of antipsychotic polypharmacy and concurrent use of hypnotics/anxiolytics in patients with schizophrenia. Notably, these data were collected before intensive instruction regarding the guidelines; therefore, we need to assess the change in the prescription pattern post guideline instruction.
AB - Background: Monopharmacy with antipsychotics and antidepressants is the first-line treatment for schizophrenia and major depressive disorder (MDD) in most clinical guidelines, while polypharmacy with psychotropic agents in the treatment of schizophrenia is common in clinical practice. There are no detailed data on the prescription patterns for inpatients with mental illness with reliable diagnoses made by treating psychiatrists. Methods: We gathered prescription data at discharge from 2177 patients with schizophrenia and 1238 patients with MDD from October 2016 to March 2018. Results: The patients with schizophrenia aged between 60 and 79 were prescribed lower doses of antipsychotics and hypnotics/anxiolytics than those aged between 40 and 59. There were significant differences between the prescription rate of antipsychotics in the patients with schizophrenia and that of antidepressants in the patients with MDD. The frequency of concomitant drugs such as anti-Parkinson drugs, anxiolytics/hypnotics and mood stabilizers in the subjects with schizophrenia prescribed antipsychotic polypharmacy was significantly higher than that with monotherapy. For the patients with schizophrenia, olanzapine, risperidone, aripiprazole, quetiapine, and blonanserin were the five most prescribed antipsychotics. For the patients with MDD, mirtazapine, duloxetine, escitalopram, trazodone and sertraline were the five most prescribed antidepressants. Conclusions: Our results showed the use of high doses of antipsychotics, high percentages of antipsychotic polypharmacy and concurrent use of hypnotics/anxiolytics in patients with schizophrenia. Notably, these data were collected before intensive instruction regarding the guidelines; therefore, we need to assess the change in the prescription pattern post guideline instruction.
KW - Antidepressants
KW - Antipsychotics
KW - EGUIDE
KW - Monopharmacy
KW - Polypharmacy
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U2 - 10.1016/j.ajp.2021.102744
DO - 10.1016/j.ajp.2021.102744
M3 - Article
C2 - 34325252
AN - SCOPUS:85111206317
SN - 1876-2018
VL - 63
JO - Asian Journal of Psychiatry
JF - Asian Journal of Psychiatry
M1 - 102744
ER -
