Use of first- and second-generation antipsychotic medications in older patients with schizophrenia in Asia (2001-2009)

Yu Tao Xiang, Julie Kreyenbuhl, Faith B. Dickerson, Gabor S. Ungvari, Chuan Yue Wang, Tian Mei Si, Edwin H. Lee, Yan Ling He, Helen F. Chiu, Shu Yu Yang, Mian Yoon Chong, Chay Hoon Tan, Ee Heok Kua, Senta Fujii, Kang Sim, Michael K. Yong, Jitendra K. Trivedi, Eun Kee Chung, Pichet Udomratn, Kok Yoon CheeNorman Sartorius, Naotaka Shinfuku

Research output: Contribution to journalArticle

Abstract

Objective: This study examined the prescribing patterns of several first- (FGAs) and second generation antipsychotic (SGAs) medications administered to older Asian patients with schizophrenia during the period between 2001 and 2009. Method: Information on hospitalized patients with schizophrenia aged 65 or older was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study (20012009). There were no older patients in Thailand, therefore data on 467 patients in eight Asian countries and territories including China, Hong Kong SAR, India, Japan, Korea, Malaysia, Singapore, and Taiwan were analysed. Cross-sectional socio-demographic data, clinical characteristics and antipsychotic prescriptions were assessed using a standardized protocol and data collection procedure. Results: Of the 467 patients, 192 patients (41.1%) received FGAs only, 166 (35.5%) received SGAs only and 109 (23.3%) received a combination of FGAs and SGAs. Of the FGAs, haloperidol was the most commonly used (31.3%; mean 9.4 ± 6.7 mg/day), followed by chlorpromazine (15.4%; mean 126.4 ± 156.4 mg/day) and sulpiride (6.6%; mean 375.0 ± 287.0 mg/day). Of the SGAs, risperidone was the most commonly used (31.5%; mean 4.5 ± 2.7 mg/day), followed by olanzapine (13.1%; mean 13.6 ± 6.5 mg/day), quetiapine (7.3%; mean 325.0 ± 237.3 mg/day) and aripiprazole (1.9%; mean 17.6 ± 7.7 mg/day). Conclusions: FGAs and higher doses of certain SGAs (risperidone, olanzapine and quetiapine) were still commonly dispensed to older Asian patients with schizophrenia. Considering older patients reduced tolerability of potentially severe side effects associated with FGAs and higher doses of certain SGAs, continuing education and training addressing the rational use of antipsychotics in this population is clearly needed.

Original languageEnglish (US)
Pages (from-to)1159-1164
Number of pages6
JournalAustralian and New Zealand Journal of Psychiatry
Volume46
Issue number12
DOIs
StatePublished - Dec 2012

Keywords

  • Asia
  • older patients
  • prescription patterns
  • schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health

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    Xiang, Y. T., Kreyenbuhl, J., Dickerson, F. B., Ungvari, G. S., Wang, C. Y., Si, T. M., Lee, E. H., He, Y. L., Chiu, H. F., Yang, S. Y., Chong, M. Y., Tan, C. H., Kua, E. H., Fujii, S., Sim, K., Yong, M. K., Trivedi, J. K., Chung, E. K., Udomratn, P., ... Shinfuku, N. (2012). Use of first- and second-generation antipsychotic medications in older patients with schizophrenia in Asia (2001-2009). Australian and New Zealand Journal of Psychiatry, 46(12), 1159-1164. https://doi.org/10.1177/0004867412453625