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


METHODS
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.
Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China. xyutly@gmail.com
Yu-Tao
YT
Xiang
Julie
J
Kreyenbuhl
Faith B
FB
Dickerson
Gabor S
GS
Ungvari
Chuan-Yue
CY
Wang
Tian-Mei
TM
Si
Edwin H
EH
Lee
Yan-Ling
YL
He
Helen F
HF
Chiu
Shu-Yu
SY
Yang
Mian-Yoon
MY
Chong
Chay-Hoon
CH
Tan
Ee-Heok
EH
Kua
Senta
S
Fujii
Kang
K
Sim
Michael K
MK
Yong
Jitendra K
JK
Trivedi
Eun-Kee
EK
Chung
Pichet
P
Udomratn
Kok-Yoon
KY
Chee
Norman
N
Sartorius
Naotaka
N
Shinfuku
D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification; D001208:Asia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003710:Demography; D004305:Dose-Response Relationship, Drug; D005260:Female; D062489:Health Impact Assessment; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D012959:Socioeconomic Factors
D014150:Antipsychotic Agents