Common use of high doses of antipsychotic medications in older Asian patients with schizophrenia (2001-2009)

Y. Xiang, Y. Li, C.U. Correll, Gabor Ungvári, H. Chiu, K. Lai, Q. Tang, W. Hao, T. Si, C. Wang, E. Lee, Y. He, S. Yang, M. Chong, E. Kua, S. Fujii, K. Sim, M.K.H. Yong, J.K. Trivedi, E. Chung & 4 others P. Udomratn, K. Chee, N. Sartorius, N. Shinfuku

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    Abstract

    Objective This study aimed to examine the use of high doses of antipsychotic medications (≥600 mg/day chlorpromazine equivalent) in older Asian patients with schizophrenia and its demographic and clinical correlates. Method Information on hospitalized patients with schizophrenia aged ≥50 years was extracted from the database of the Research on Asian Psychotropic Prescription Patterns study (2001-2009). Data on 2203 patients in six Asian countries and territories, including China, Hong Kong, Japan, Korea, Singapore and Taiwan, were analyzed. Socio-demographic and clinical characteristics and antipsychotic prescriptions were recorded. Results The frequency for high-dose antipsychotic medications was 36.0% overall, with 38.4% in 2001, 33.3% in 2004 and 36.0% in 2009. Multiple logistic regression analysis of the whole sample showed that compared to patients receiving low-medium antipsychotic doses, those on high doses had a longer illness duration (odds ratio (OR): 2.0, 95% confidence interval (CI):1.2-3.3, p = 0.008), were more likely in the 50-59-year group (OR: 0.95, 95% CI: 0.94-0.97, p <0.001), more often had current positive (OR: 1.5, 95% CI: 1.2-1.8, p <0.001) or negative symptoms (OR: 1.3, 95% CI: 1.03-1.6, p = 0.03), and more commonly received antipsychotic polypharmacy (OR: 5.3, 95% CI: 4.1-6.7, p <0.001). Extrapyramidal symptoms (p = 0.25) and tardive dyskinesia (p = 0.92) were not more frequent in the high-dose group. Conclusions High doses of antipsychotic medications were used in more than one third of older Asian patients with schizophrenia. The reasons for the frequent use of high antipsychotic doses in older Asian patients warrant further investigation. © 2013 John Wiley & Sons, Ltd.
    Original languageEnglish
    Pages (from-to)359-366
    JournalInternational Journal of Geriatric Psychiatry
    Volume29
    Issue number4
    DOIs
    Publication statusPublished - 2014

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    Antipsychotic Agents
    Schizophrenia
    Odds Ratio
    Confidence Intervals
    Prescriptions
    Demography
    Polypharmacy
    Singapore
    Chlorpromazine
    Hong Kong
    Korea
    Nuclear Family
    Taiwan
    China
    Japan
    Logistic Models
    Regression Analysis
    Databases
    Research

    Cite this

    Xiang, Y. ; Li, Y. ; Correll, C.U. ; Ungvári, Gabor ; Chiu, H. ; Lai, K. ; Tang, Q. ; Hao, W. ; Si, T. ; Wang, C. ; Lee, E. ; He, Y. ; Yang, S. ; Chong, M. ; Kua, E. ; Fujii, S. ; Sim, K. ; Yong, M.K.H. ; Trivedi, J.K. ; Chung, E. ; Udomratn, P. ; Chee, K. ; Sartorius, N. ; Shinfuku, N. / Common use of high doses of antipsychotic medications in older Asian patients with schizophrenia (2001-2009). In: International Journal of Geriatric Psychiatry. 2014 ; Vol. 29, No. 4. pp. 359-366.
    @article{c9b5abac497648e3a4a59d6c152b3b41,
    title = "Common use of high doses of antipsychotic medications in older Asian patients with schizophrenia (2001-2009)",
    abstract = "Objective This study aimed to examine the use of high doses of antipsychotic medications (≥600 mg/day chlorpromazine equivalent) in older Asian patients with schizophrenia and its demographic and clinical correlates. Method Information on hospitalized patients with schizophrenia aged ≥50 years was extracted from the database of the Research on Asian Psychotropic Prescription Patterns study (2001-2009). Data on 2203 patients in six Asian countries and territories, including China, Hong Kong, Japan, Korea, Singapore and Taiwan, were analyzed. Socio-demographic and clinical characteristics and antipsychotic prescriptions were recorded. Results The frequency for high-dose antipsychotic medications was 36.0{\%} overall, with 38.4{\%} in 2001, 33.3{\%} in 2004 and 36.0{\%} in 2009. Multiple logistic regression analysis of the whole sample showed that compared to patients receiving low-medium antipsychotic doses, those on high doses had a longer illness duration (odds ratio (OR): 2.0, 95{\%} confidence interval (CI):1.2-3.3, p = 0.008), were more likely in the 50-59-year group (OR: 0.95, 95{\%} CI: 0.94-0.97, p <0.001), more often had current positive (OR: 1.5, 95{\%} CI: 1.2-1.8, p <0.001) or negative symptoms (OR: 1.3, 95{\%} CI: 1.03-1.6, p = 0.03), and more commonly received antipsychotic polypharmacy (OR: 5.3, 95{\%} CI: 4.1-6.7, p <0.001). Extrapyramidal symptoms (p = 0.25) and tardive dyskinesia (p = 0.92) were not more frequent in the high-dose group. Conclusions High doses of antipsychotic medications were used in more than one third of older Asian patients with schizophrenia. The reasons for the frequent use of high antipsychotic doses in older Asian patients warrant further investigation. {\circledC} 2013 John Wiley & Sons, Ltd.",
    author = "Y. Xiang and Y. Li and C.U. Correll and Gabor Ungv{\'a}ri and H. Chiu and K. Lai and Q. Tang and W. Hao and T. Si and C. Wang and E. Lee and Y. He and S. Yang and M. Chong and E. Kua and S. Fujii and K. Sim and M.K.H. Yong and J.K. Trivedi and E. Chung and P. Udomratn and K. Chee and N. Sartorius and N. Shinfuku",
    year = "2014",
    doi = "10.1002/gps.4011",
    language = "English",
    volume = "29",
    pages = "359--366",
    journal = "International Journal of Geriatric Psychiatry",
    issn = "0885-6230",
    publisher = "John Wiley & Sons",
    number = "4",

    }

    Xiang, Y, Li, Y, Correll, CU, Ungvári, G, Chiu, H, Lai, K, Tang, Q, Hao, W, Si, T, Wang, C, Lee, E, He, Y, Yang, S, Chong, M, Kua, E, Fujii, S, Sim, K, Yong, MKH, Trivedi, JK, Chung, E, Udomratn, P, Chee, K, Sartorius, N & Shinfuku, N 2014, 'Common use of high doses of antipsychotic medications in older Asian patients with schizophrenia (2001-2009)' International Journal of Geriatric Psychiatry, vol. 29, no. 4, pp. 359-366. https://doi.org/10.1002/gps.4011

    Common use of high doses of antipsychotic medications in older Asian patients with schizophrenia (2001-2009). / Xiang, Y.; Li, Y.; Correll, C.U.; Ungvári, Gabor; Chiu, H.; Lai, K.; Tang, Q.; Hao, W.; Si, T.; Wang, C.; Lee, E.; He, Y.; Yang, S.; Chong, M.; Kua, E.; Fujii, S.; Sim, K.; Yong, M.K.H.; Trivedi, J.K.; Chung, E.; Udomratn, P.; Chee, K.; Sartorius, N.; Shinfuku, N.

    In: International Journal of Geriatric Psychiatry, Vol. 29, No. 4, 2014, p. 359-366.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Common use of high doses of antipsychotic medications in older Asian patients with schizophrenia (2001-2009)

    AU - Xiang, Y.

    AU - Li, Y.

    AU - Correll, C.U.

    AU - Ungvári, Gabor

    AU - Chiu, H.

    AU - Lai, K.

    AU - Tang, Q.

    AU - Hao, W.

    AU - Si, T.

    AU - Wang, C.

    AU - Lee, E.

    AU - He, Y.

    AU - Yang, S.

    AU - Chong, M.

    AU - Kua, E.

    AU - Fujii, S.

    AU - Sim, K.

    AU - Yong, M.K.H.

    AU - Trivedi, J.K.

    AU - Chung, E.

    AU - Udomratn, P.

    AU - Chee, K.

    AU - Sartorius, N.

    AU - Shinfuku, N.

    PY - 2014

    Y1 - 2014

    N2 - Objective This study aimed to examine the use of high doses of antipsychotic medications (≥600 mg/day chlorpromazine equivalent) in older Asian patients with schizophrenia and its demographic and clinical correlates. Method Information on hospitalized patients with schizophrenia aged ≥50 years was extracted from the database of the Research on Asian Psychotropic Prescription Patterns study (2001-2009). Data on 2203 patients in six Asian countries and territories, including China, Hong Kong, Japan, Korea, Singapore and Taiwan, were analyzed. Socio-demographic and clinical characteristics and antipsychotic prescriptions were recorded. Results The frequency for high-dose antipsychotic medications was 36.0% overall, with 38.4% in 2001, 33.3% in 2004 and 36.0% in 2009. Multiple logistic regression analysis of the whole sample showed that compared to patients receiving low-medium antipsychotic doses, those on high doses had a longer illness duration (odds ratio (OR): 2.0, 95% confidence interval (CI):1.2-3.3, p = 0.008), were more likely in the 50-59-year group (OR: 0.95, 95% CI: 0.94-0.97, p <0.001), more often had current positive (OR: 1.5, 95% CI: 1.2-1.8, p <0.001) or negative symptoms (OR: 1.3, 95% CI: 1.03-1.6, p = 0.03), and more commonly received antipsychotic polypharmacy (OR: 5.3, 95% CI: 4.1-6.7, p <0.001). Extrapyramidal symptoms (p = 0.25) and tardive dyskinesia (p = 0.92) were not more frequent in the high-dose group. Conclusions High doses of antipsychotic medications were used in more than one third of older Asian patients with schizophrenia. The reasons for the frequent use of high antipsychotic doses in older Asian patients warrant further investigation. © 2013 John Wiley & Sons, Ltd.

    AB - Objective This study aimed to examine the use of high doses of antipsychotic medications (≥600 mg/day chlorpromazine equivalent) in older Asian patients with schizophrenia and its demographic and clinical correlates. Method Information on hospitalized patients with schizophrenia aged ≥50 years was extracted from the database of the Research on Asian Psychotropic Prescription Patterns study (2001-2009). Data on 2203 patients in six Asian countries and territories, including China, Hong Kong, Japan, Korea, Singapore and Taiwan, were analyzed. Socio-demographic and clinical characteristics and antipsychotic prescriptions were recorded. Results The frequency for high-dose antipsychotic medications was 36.0% overall, with 38.4% in 2001, 33.3% in 2004 and 36.0% in 2009. Multiple logistic regression analysis of the whole sample showed that compared to patients receiving low-medium antipsychotic doses, those on high doses had a longer illness duration (odds ratio (OR): 2.0, 95% confidence interval (CI):1.2-3.3, p = 0.008), were more likely in the 50-59-year group (OR: 0.95, 95% CI: 0.94-0.97, p <0.001), more often had current positive (OR: 1.5, 95% CI: 1.2-1.8, p <0.001) or negative symptoms (OR: 1.3, 95% CI: 1.03-1.6, p = 0.03), and more commonly received antipsychotic polypharmacy (OR: 5.3, 95% CI: 4.1-6.7, p <0.001). Extrapyramidal symptoms (p = 0.25) and tardive dyskinesia (p = 0.92) were not more frequent in the high-dose group. Conclusions High doses of antipsychotic medications were used in more than one third of older Asian patients with schizophrenia. The reasons for the frequent use of high antipsychotic doses in older Asian patients warrant further investigation. © 2013 John Wiley & Sons, Ltd.

    U2 - 10.1002/gps.4011

    DO - 10.1002/gps.4011

    M3 - Article

    VL - 29

    SP - 359

    EP - 366

    JO - International Journal of Geriatric Psychiatry

    JF - International Journal of Geriatric Psychiatry

    SN - 0885-6230

    IS - 4

    ER -