Use of first- and second-generation antipsychotic medications in older patients with schizophrenia in Asia (2001-2009)
Use of first- and second-generation antipsychotic medications in older patients with schizophrenia in Asia (2001-2009)
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DOI：
10.1177/0004867412453625
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发表时间：
2012-12-01
影响因子：
4.6
通讯作者：
Shinfuku, Naotaka
中科院分区：
文献类型：
--
作者：
Xiang, Yu-Tao;Kreyenbuhl, Julie;Shinfuku, Naotaka
目的：本研究调查了2001年至2009年期间亚洲老年精神分裂症患者使用的几种第一代（FGA）和第二代抗精神病药（SGAs）的处方模式。方法：65岁或以上精神分裂症住院患者的信息摘自亚洲精神药物处方模式研究（REAP）研究（2001-2009）的数据库。泰国没有老年患者，因此分析了八个亚洲国家和地区（包括中国、香港特别行政区、印度、日本、韩国、马来西亚、新加坡和台湾）的467名患者的数据。横断面的社会人口学数据，临床特征和抗精神病药物处方进行了评估，使用标准化的协议和数据收集procedure.Results：467例患者中，192例（41.1%）只接受FGA，166例（35.5%）只接受SGAs和109例（23.3%）接受FGA和SGAs的组合。在FGA中，氟哌啶醇是最常用的（31.3%;平均9.4 +/- 6.7 mg/天），其次是氯丙嗪（15.4%;平均126.4 +/- 156.4 mg/天）和舒必利（6.6%;平均375.0 +/- 287.0 mg/天）。在SGAs中，利培酮是最常用的（31.5%;平均4.5 ± 2.7 mg/天），其次是奥氮平（13.1%;平均13.6 +/- 6.5 mg/天），奎替鲁胺（7.3%;平均325.0 +/- 237.3 mg/天）和阿立哌唑（1.9%;平均17.6 +/- 7.7 mg/天）。FGA和更高剂量的某些SGAs（利培酮，奥氮平和奎替鲁）仍然经常分发给老年亚洲精神分裂症患者。考虑到老年患者对与FGA和较高剂量的某些SGAs相关的潜在严重副作用的耐受性降低，显然需要继续教育和培训，以解决在这一人群中合理使用抗精神病药物的问题。
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 (2001-2009). 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.