International trends in antipsychotic use: A study in 16 countries, 2005–2014

Abstract

The objective of this study was to assess international trends in antipsychotic use, using a standardised methodology. A repeated cross-sectional design was applied to data extracts from the years 2005 to 2014 from 16 countries worldwide. During the study period, the overall prevalence of antipsychotic use increased in 10 of the 16 studied countries. In 2014, the overall prevalence of antipsychotic use was highest in Taiwan (78.2/1000 persons), and lowest in Colombia (3.2/1000). In children and adolescents (0-19 years), antipsychotic use ranged from 0.5/1000 (Lithuania) to 30.8/1000 (Taiwan). In adults (20-64 years), the range was 2.8/1000 (Colombia) to 78.9/1000 (publicly insured US population), and in older adults (65+ years), antipsychotic use ranged from 19.0/1000 (Colombia) to 149.0/1000 (Taiwan). Atypical antipsychotic use increased in all populations (range of atypical/typical ratio: 0.7 (Taiwan) to 6.1 (New Zealand, Australia)). Quetiapine, risperidone, and olanzapine were most frequently prescribed. Prevalence and patterns of antipsychotic use varied markedly between countries. In the majority of populations, antipsychotic utilisation and especially the use of atypical antipsychotics increased over time. The high rates of antipsychotic prescriptions in older adults and in youths in some countries merit further investigation and systematic pharmacoepidemiologic monitoring.

Trends in utilization and dosing of antipsychotic drugs in Scandinavia: Comparison of 2006 and 2016

“…However, there is significant variation in the evidence of efficacy for the treatment of these conditions . The overall prevalence of antipsychotic use has been increasing, and population studies have found the use of antipsychotic drugs in non‐psychotic disorders such as depression, anxiety, autism spectrum disorders to be common . In Norway, increasing use of the second‐generation antipsychotic quetiapine was found to coincide with decreasing mean doses and increased prescribing for non‐psychotic disorders, indicating increasing off‐label use .…”

No differences in olanzapine‐ and risperidone‐related weight gain between women and men: a meta‐analysis of short‐ and middle‐term treatment

“…Sufficient data were present only for weight changes in case of olanzapine and risperidone. Latest pharmacoepidemiological data report that olanzapine and risperidone are across the three most prescribed AP and, therefore, the presented findings represent a predominant group of patients using AP . Thus, the role of sex has not been explicitly addressed in sufficient detail in a sufficient number of studies hampering definitive conclusions.…”

The impact of permissive and restrictive pharmaceutical policies on quetiapine dispensing: Evaluating a policy pendulum using interrupted time series analysis

“…Following the policy change, we observed a sustained increase in the rate of 25-mg quetiapine dispensing by 11/month (95% CI: [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] and all other quetiapine strengths combined by 14/month (95% CI: [8][9][10][11][12][13][14][15][16][17][18][19][20]. We did not observe a monthly increase in dispensing rate (ramp) for all antipsychotics minus quetiapine, but there was a step increase of 2162 (95% CI: 773-1371) dispensings that occurred gradually over the study period (Table 2).…”

“…Quetiapine is a short acting antipsychotic available in immediate and extended release formulations, with level 1 evidence to support its use in treating schizophrenia and bipolar I disorder . Since its initial listing for public subsidy in Australia in 2000, quetiapine has become the most frequently dispensed antipsychotic in Australia and many other countries …”

“…1,2 Since its initial listing for public subsidy in Australia in 2000, quetiapine has become the most frequently dispensed antipsychotic in Australia and many other countries. 3,4 The recommended daily therapeutic quetiapine dose is between 300 and 800 mg for its main indications. 5 The 25-mg quetiapine strength is only registered and subsidized for dose titration.…”