title: Effects of age and age of onset on prescribed antipsychotic dose in schizophrenia spectrum disorders: a survey of 1,418 patients in Japan.
abstract: OBJECTIVE
  The relationship between age and prescribed antipsychotic dose in patients with schizophrenia has been examined by assuming only a linear correlation in two age subgroups at most. The age of illness onset has also not been under adequate consideration in past prescription surveys. The objective of this study was to better evaluate these age effects on antipsychotic dose prescribed in these patients across a broad age range.
  
  
  METHODS
  Review of prescriptions for antipsychotic medications in patients with schizophrenia spectrum disorders was conducted across 30 sites in Tokyo. A total of 1,418 patients (655 inpatients, 763 males, age range: 16.6-90.2 years) were studied.
  
  
  RESULTS
  Age had significant effects on prescribed antipsychotic dose; the dose increased with age through the third decade, subsequently plateaued, and decreased after the fifth decade. The age of illness onset also had significant effects on the dose; late-onset schizophrenia (LOS) and very-late-onset schizophrenia-like psychoses (VLOS) patients received lower doses than early onset schizophrenia (EOS) patients. LOS and VLOS patients who did not experience any hospitalization for the previous year were treated with (1/2) and (1/3), respectively, of the dose for EOS of comparable current age.
  
  
  CONCLUSIONS
  Our results suggested biphasic effects of age on antipsychotic dose prescribed in patients with schizophrenia spectrum disorders. The natural history of schizophrenia and physiological aging may contribute to this inverted U-shaped relationship. In addition, our results may add another evidence of distinction among EOS, LOS, and VLOS from a clinical psychopharmacological perspective.
authors.affiliation: Department of Neuropsychiatry, Keio University, School of Medicine, Tokyo, Japan. mcn41320@biglobe.ne.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uchida
authors.forename: Takefumi
authors.initials: T
authors.lastname: Suzuki
authors.forename: David C
authors.initials: DC
authors.lastname: Mamo
authors.forename: Benoit H
authors.initials: BH
authors.lastname: Mulsant
authors.forename: Akira
authors.initials: A
authors.lastname: Tanabe
authors.forename: Ataru
authors.initials: A
authors.lastname: Inagaki
authors.forename: Koichiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Gohei
authors.initials: G
authors.lastname: Yagi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tomita
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents