Sex Differences in Use of Psychotropic Drugs and Drug-Induced Side Effects in Schizophrenia Patients: Findings of the Research on Asia Psychotropic Prescription (REAP) Studies

Xiang, Yu‐Tao; Wang, Chuanyue; Si, Tianmei; H, Lee; He, Yanling; Ungvári, Gábor S.; Chiu, Helen F. K.; Yang, Shuyu; Chong, Mian‐Yoon; Shinfuku, Naotaka; Tan, Chay Hoon; Kua, Ee Heok; Fujii, Senta; Sim, Kang; Yong, K.H.; Jk, Trivedi; Chung, Eun Kee; Udomratn, Pichet; Chee, Kok Yoon; Sartorius, Norman

doi:10.3109/00048674.2010.538839

Cited by 22 publications

(9 citation statements)

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“…Additionally, demographic features such as age, gender, ethnicity, educational background, insurance coverage, polypharmacy, and history of substance abuse should also be taken into account when considering treatment with LAIs [40,42-48]. …”

Section: Introductionmentioning

confidence: 99%

Long-acting antipsychotic drugs for the treatment of schizophrenia: use in daily practice from naturalistic observations

et al. 2012

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BackgroundCurrent guidelines suggest specific criteria for oral or long-acting injectable antipsychotic drugs (LAIs). This review aims to describe the demographic and clinical characteristics of the ideal profile of the patient with schizophrenia treated with LAIs, through the analysis of nonrandomized studies.MethodsA systematic review of nonrandomized studies in English was performed attempting to analyze the factors related to the choice and use of LAIs in daily practice. The contents were outlined using the Cochrane methods for nonrandomized studies and the variables included demographic as well as clinical characteristics. The available literature did not allow any statistical analysis that could be used to identify the ideal profile of patients with schizophrenia to be treated with LAIs.ResultsEighty publications were selected and reviewed. Prevalence of LAI use ranged from 4.8% to 66%. The only demographic characteristics that were consistently assessed through retrieved studies were age (38.5 years in the 1970’s, 35.8 years in the 1980’s, 39.3 years in the 1990’s, to 39.5 years in the 2000’s) and gender (male > female).Efficacy was assessed through the use of various symptom scales and other indirect measurements; safety was assessed through extrapyramidal symptoms and the use of anticholinergic drugs, but these data were inconsistent and impossible to pool. Efficacy and safety results reported in the different studies yielded a good therapeutic profile with a maximum of 74% decrease in hospital admissions and the prevalence of extrapyramidal symptoms with LAIs consistently increased at 6, 12, 18, and 24 months (35.4%, 37.1%, 36.9%, and 41.3%, respectively).ConclusionsThis analysis of the available literature strongly suggests that further observational studies on patients with schizophrenia treated with LAIs are needed to systematically assess their demographic and clinical characteristics and the relationships between them and patient outcome.Besides the good efficacy and safety profile of LAIs, health care staff must also take into account the importance of establishing a therapeutic alliance with the patient and his/her relatives when selecting the most appropriate treatment. LAIs seem to be a good choice not only because of their good safety and efficacy profile, but also because they improve compliance, a key factor to improving adherence and to establishing a therapeutic alliance between patients with schizophrenia, their relatives, and their health care providers.

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Section: Introductionmentioning

confidence: 99%

Long-acting antipsychotic drugs for the treatment of schizophrenia: use in daily practice from naturalistic observations

et al. 2012

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“…The change (improvement) in GSRH on Q100 was not significant in the total sample (see Table 3). However, sex differences in drug effects are common (Golomb, 2013;Golomb & Evans, 2008;Golomb, Evans, Dimsdale, & White, 2012;Golomb & Koperski, 2013a, 2013bGolomb, Koperski, & White, 2012), including in drug classes relevant to GWV (Menich, Costello, Hoffman, Hershey, & Engler, 2001;Pittman, 2002;Schieszer, 2003) and extending to drug transporters and metabolizing enzymes (Classen & Netter, 1985;Finnen & Hassall, 1984;Ofotokun, 2005;Skett & Paterson, 1985;Xiang et al, 2011). The study sample was predominantly male (85%, comparable to the 83% overall GWV with fatiguing illness who were male (Kang, Natelson, Mahan, Lee, & Murphy, 2003)), and male sex significantly predicted GSRH change in the total sample (p = 0.031).…”

Section: Resultsmentioning

confidence: 97%

Coenzyme Q10 Benefits Symptoms in Gulf War Veterans: Results of a Randomized Double-Blind Study

et al. 2014

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We sought to assess whether coenzyme Q10 (CoQ10) benefits the chronic multisymptom problems that affect one-quarter to one-third of 1990-1 Gulf War veterans, using a randomized, double-blind, placebo-controlled study. Participants were 46 veterans meeting Kansas and Centers for Disease Control criteria for Gulf War illness. Intervention was PharmaNord (Denmark) CoQ10 100 mg per day (Q100), 300 mg per day (Q300), or an identical-appearing placebo for 3.5 ± 0.5 months. General self-rated health (GSRH), the primary outcome, differed across randomization arms at baseline, and sex significantly predicted GSRH change, compelling adjustment for baseline GSRH and prompting sex-stratified analysis. GSRH showed no significant benefit in the combined-sex sample. Among males (85% of participants), Q100 significantly benefited GSRH versus placebo and versus Q300, providing emphasis on Q100. Physical function (summary performance score, SPS) improved on Q100 versus placebo. A rise in CoQ10 approached significance as a predictor of improvement in GSRH and significantly predicted SPS improvement. Among 20 symptoms each present in half or more of the enrolled veterans, direction-of-difference on Q100 versus placebo was favorable for all except sleep problems; sign test 19:1, p=0.00004) with several symptoms individually significant. Significance for these symptoms despite the small sample underscores large effect sizes, and an apparent relation of key outcomes to CoQ10 change increases prospects for causality. In conclusion, Q100 conferred benefit to physical function and symptoms in veterans with Gulf War illness. Examination in a larger sample is warranted, and findings from this study can inform the conduct of a larger trial.

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“…menstruation and postpartum), and oestrogen has been suggested as a potential new treatment approach . Men tend to require higher doses of antipsychotics, and have less prominent delusions and hallucinations but more prominent negative symptoms than women . Androgens may also have antipsychotic and antidepressive potential and, in addition, patients with schizophrenia tend to show reduced testosterone levels .…”

Section: Sex Steroid Hormones and Bdnf‐trkb Signalling In Schizophrenmentioning

confidence: 99%

Interaction of Sex Steroid Hormones and Brain‐Derived Neurotrophic Factor‐Tyrosine Kinase B Signalling: Relevance to Schizophrenia and Depression

Hill

2012

J Neuroendocrinology

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Sex steroid hormones and neurotrophic factors are involved in pruning and shaping the developing brain and have been implicated in the pathogenesis of neurodevelopmental disorders. Sex steroid hormones are also involved in the regulation of brain-derived neurotrophic factor expression. A review of the literature is provided on the relationship between brain-derived neurotrophic factor and sex steroid hormones, as well as the mechanisms behind this interaction, in the context of how this relationship may be involved in the development of neurodevelopmental psychiatric illnesses, such as schizophrenia and depression.

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Sex Differences in Use of Psychotropic Drugs and Drug-Induced Side Effects in Schizophrenia Patients: Findings of the Research on Asia Psychotropic Prescription (REAP) Studies

Abstract: Sex is one of the independent contributors to psychotropic prescription and side effects in Asian schizophrenia patients. Psychopharmacological treatment guidelines for schizophrenia should consider the sexes separately.

Cited by 22 publications

References 50 publications

Long-acting antipsychotic drugs for the treatment of schizophrenia: use in daily practice from naturalistic observations

Long-acting antipsychotic drugs for the treatment of schizophrenia: use in daily practice from naturalistic observations

Coenzyme Q10 Benefits Symptoms in Gulf War Veterans: Results of a Randomized Double-Blind Study

Interaction of Sex Steroid Hormones and Brain‐Derived Neurotrophic Factor‐Tyrosine Kinase B Signalling: Relevance to Schizophrenia and Depression

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