Adjunctive Mood Stabilizer and Benzodiazepine Use in Older Asian Patients with Schizophrenia, 2001–2009

Abstract

The use of MS and BZD is not uncommon in older Asian patients with schizophrenia. Given the paucity of empirical data on the efficacy of these agents in individuals with schizophrenia of any age and concerns about added side effects in older patients in particular, the rationale for the prescription of these agents in this population warrants further examination.

Coprescription of mood stabilizers in schizophrenia, dosing, and clinical correlates: An international study

“…Use of cotreatment with lithium or an anticonvulsant MS varied markedly among study sites, ranging from 36.2% of subjects in PR China to 2.00% in Bangladesh—regional variance that remains unexplained. The overall mean rate of MS use, at 13.6% accords well with reports from Europe and North America, ranging from 7% to 27% (Buchanan et al, 2002; Haro & Salvador‐Carulla, 2006; Szkultecka‐Debek et al, 2016), but is somewhat lower than rates of 20.4%–27.7% in previous Asian surveys (Sim et al, 2011; Xiang et al, 2012). Accordingly, these findings add to the impression that use of MSs is quite prevalent in the treatment of patients with schizophrenia throughout the world.…”

“…Contemporary treatment of schizophrenia involves antipsychotic drugs and rehabilitative methods (Owen et al, 2016), as well as the use of adjunctive psychotropic medications. Mood stabilizers (MSs) have been used to augment the effects of antipsychotic drugs for schizophrenia, at rates ranging from 7% to 28% especially in Europe and North America (Buchanan, Kreyenbuhl, Zito, & Lehman, 2002; Haro & Salvador‐Carulla, 2006; Sim et al, 2011; Szkultecka‐Debek et al, 2016; Xiang et al, 2012). However, evidence that such adjunctive interventions are effective and safe is limited and inconsistent.…”

“…Despite evidently widespread international use of MSs for the treatment of patients with schizophrenia, there are cogent reasons to further evaluate their clinical use and value, especially in Asia, where such studies have been rare, geographically limited, and usually without consideration of drug doses and related factors (Sim et al, 2011; Xiang et al, 2012).…”

Concurrent benzodiazepine use in older adults treated with antidepressants in Asia

“…In Japan, 20-50% of older persons with psychiatric patients are prescribed benzodiazepines (Uchida et al, 2009). Another survey in Asia found that 20.7% of older patients with schizophrenia received benzodiazepines (Xiang et al, 2012).…”

Optimization of psychopharmacotherapy for schizophrenia in a male, locked, non-acute unit serving for persistently ill patients over one year

“…Nevertheless, in the real-world, many patients remain refractory to treatment with a single antipsychotic agent and are indeed treated with other psychotropic medications such as benzodiazepines and mood stabilizers (Procyshyn et al, 2010;Tor et al, 2011;Xiang et al, 2012b) despite limited evidencebase (Basan et al, 2004;Leucht et al, 2007;Gillies et al, 2013).…”