Prescription of antipsychotic and concomitant medications for adult Asian schizophrenia patients: Findings of the 2016 Research on Asian Psychotropic Prescription Patterns (REAP) survey

Dong, Min; Zeng, Liang; Zhang, Qinge; Yang, Shu Yu; Chen, Lian‐Yu; Najoan, Eunice; Kallivayalil, Roy Abraham; Viboonma, Kittisak; Jamaluddin, Ruzita; Javed, Afzal; Hoa, Duong Thi Quynh; Iida, Hitoshi; Sim, Kang; Swe, Thiha; He, Yan; Park, Yong Chon; Ahmed, Helal Uddin; Alwis, Angelo de; Chiu, Helen Fung Kum; Sartorius, Norman; Tan, Chay Hoon; Chong, Mian Yoon; Shinfuku, Naotaka; Lin, Shih Ku; Avasthi, Ajit; Grover, Sandeep; Ng, Chee H.; Ungvári, Gábor S.; Xiang, Yu Tao

doi:10.1016/j.ajp.2019.08.010

Cited by 41 publications

(50 citation statements)

References 74 publications

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“…Specifically for Asian regions, the recent Asian collaborative schizophrenia study 18 including 15 countries (n=3,357) found that approximately 43% of participants were on APP which was substantially higher rates compared to that (32%) of previous systematic study. 17 The mean dose of AP by chlorpromazine equivalents (CPZeq) was 424 mg/d.…”

Section: Prevalence Of Appmentioning

confidence: 74%

“…Such high prevalences of APP has been also consistently found in numerous independent studies in different geographic regions such as Korea, China, Brazil, Canada, America, and Japan. [18][19][20][21][22][23] There has been no clear determination of how many number of APs are commonly used in APP, which is found to create a variable range of AP numbers. According to the extensive meta-analysis, 17 17.8% were taking two APs and 0.2% were taking ≥3 antipsychotics.…”

Section: Prevalence Of Appmentioning

confidence: 99%

Section: Prevalence Of Appmentioning

confidence: 99%

See 2 more Smart Citations

Antipsychotic Polypharmacy in Treatment of Schizophrenia; Should or Should Not?

Pae

2020

Chonnam Med J

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Antipsychotics have been utilized as the standard treatment for schizophrenia regardless of illness phase where antipsychotic monotherapy (APM) is routinely recommended as the gold standard rather than antipsychotic polypharmacy (APP). However, approximately 20 to 40% of patients with schizophrenia do not respond to APM based on randomized controlled clinical trials and large practical clinical trials indicating that the subgroup of patients with schizophrenia would need differential treatment approaches beyond traditional treatment strategies such as APM. Numerous studies have supported the use of APP in particular for patients with certain clinical situations including: failure to show efficacy or tolerability from treatment with APM, need for different treatment for targeting specific symptom domains, severe illness, failure to treatment with clozapine, skepticism about following treatment guidelines, or cross titration periods. Furthermore, recent large cohort studies and practical clinical trials have proposed more benefits of APP rather than APM in terms of rehospitalization, mortality, and specific symptoms. APP has recently become more widely utilized and recognized as one of the next treatment strategies to clinicians for patients with schizophrenia. Some experts have already proposed the revision of treatment guidelines incorporating APP as evidence-based treatment option for certain patients with schizophrenia. Taken together, APP now deserves an evidence-based and acceptable treatment strategy, not an empirical or preferential treatment approach for treatment of schizophrenia in contemporary clinical practice.

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Section: Prevalence Of Appmentioning

confidence: 74%

Section: Prevalence Of Appmentioning

confidence: 99%

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Antipsychotic Polypharmacy in Treatment of Schizophrenia; Should or Should Not?

Pae

2020

Chonnam Med J

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“…Benzodiazepines and benzodiazepine related drugs (BZRD), taken by 30% to 60% of individuals with schizophrenia or bipolar disorder, are other concerns. [33][34][35][36] Neutropenia and its extreme form agranulocytosis can occur with a variety of antipsychotics and mood-stabilisers, particularly with clozapine and carbamazepine. 37 Some of the agents used to treat COVID-19 infection such as chloroquine, hydroxychloroquine, azithromycin, and lopinavir can also cause neutropenia.…”

Section: Other Risk Factors Which May Specifically Associated With Sementioning

confidence: 99%

Death associated with coronavirus (COVID-19) infection in individuals with severe mental disorders in Sweden during the early months of the outbreak – a exploratory cross-sectional analysis of a population-based register study

Maripuu

Bendix

Öhlund

et al. 2020

Preprint

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Background: Individuals with severe mental disorder (SMD) have a higher risk of somatic comorbidity and mortality than the rest of the population. We set up a population-based study to assess whether individuals with SMD had a higher risk of death associated with a COVID-19 infection (COVID-19 associated death) than individuals without SMD. Methods: Exploratory analysis with a cross-sectional design in the framework of a population-based register study covering the entire Swedish population. The Swedish Board for Health and Welfare (Socialstyrelsen) provided anonymised tabulated summary data for further analysis. We compared numbers of COVID-19 associated death in individuals with SMD (cases) and without SMD (controls). We calculated the odds ratio (OR) for the whole sample and by age group and four potential risk factors, namely diabetes, cardiovascular disease, hypertension, chronic lung disease. Results: The sample comprised of 7,923,859 individuals, 103,999 with SMD and 7,819,860 controls. There were 130 (0.1%) COVID-19 associated deaths in the SMD group and 4945 (0.06%) in the control group, corresponding to an OR of 1.98 (CI 1.66-2.35; p < 0.001). The odds were fourfold in the age group between 60 and 79 years. Cardiovascular diseases increased the odds by 50%. Individuals with SMD without any of the risk factors under study had three-folds odds of COVID-19 associated death. Conclusion: Our preliminary results suggest that individuals with SMD are a further group at increased risk of COVID-19 associated death. The factors contributing to this increased mortality risk require clarification.

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“…However, these comparisons of the effectiveness of antipsychotics reported in studies in different countries must be interpreted with caution because of differences in the study methodologies, medication variables (e.g., usual dosage and local prescription traditions) and other confounding factors 32 . For example, antipsychotic doses for patients with schizophrenia, the proportion of antipsychotic polypharmacy, and the use of concomitant medications differed across countries/territories 33,34 . Furthermore, a recent large-scale observational study reported that clozapine plus aripiprazole resulted in a better outcome than any other antipsychotic treatment 35 .…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of antipsychotic drugs in schizophrenia: a 10-year retrospective study in a Korean tertiary hospital

Lee

Kim

et al. 2020

npj Schizophr

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Extensive research has been carried out on the comparative effectiveness of antipsychotic medications. Most studies, however, have been performed in Western countries. The purpose of this study was to compare the effectiveness, indicated by time to any-cause discontinuation, of antipsychotic drugs in a large number of patients with schizophrenia in South Korea. We identified 1458 patients with schizophrenia or schizophreniform disorder who were treated with antipsychotic medications using a clinical data warehouse at the Seoul National University Hospital between March 2005 and February 2014. Kaplan–Meier survival analyses were used to estimate the time to discontinuation of antipsychotic drugs. We compared the survival curves of different antipsychotics using log-rank tests. Overall, the median time to discontinuation for any cause was 133 days (95% CI, 126–147). The longest time to discontinuation was observed for clozapine, followed by aripiprazole, paliperidone, olanzapine, amisulpride, risperidone, quetiapine, ziprasidone, and haloperidol. Specifically, clozapine was significantly different from all other antipsychotic drugs (all p < 0.001). Aripiprazole also had a significantly longer time to discontinuation than amisulpride (p = 0.001), risperidone (p < 0.001), quetiapine (p < 0.001), ziprasidone (p < 0.001), and haloperidol (p < 0.001). In Asian patients with schizophrenia, clozapine was the most effective antipsychotic in terms of time to discontinuation, followed by aripiprazole. This study extends the findings of previous effectiveness studies from Western populations and suggests the need to develop guidelines for the pharmacotherapy of schizophrenia tailored to Asian individuals.

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Prescription of antipsychotic and concomitant medications for adult Asian schizophrenia patients: Findings of the 2016 Research on Asian Psychotropic Prescription Patterns (REAP) survey

Cited by 41 publications

References 74 publications

Antipsychotic Polypharmacy in Treatment of Schizophrenia; Should or Should Not?

Antipsychotic Polypharmacy in Treatment of Schizophrenia; Should or Should Not?

Death associated with coronavirus (COVID-19) infection in individuals with severe mental disorders in Sweden during the early months of the outbreak – a exploratory cross-sectional analysis of a population-based register study

Effectiveness of antipsychotic drugs in schizophrenia: a 10-year retrospective study in a Korean tertiary hospital

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