Adjunctive mood stabilizer treatment for hospitalized schizophrenia patients: Asia psychotropic prescription study (2001–2008)

Sim, Kang; Yong, Kian Hui; Chan, Yiong Huak; Tor, Phern‐Chern; Xiang, Yu‐Tao; Wang, Chuanyue; H, Lee; Fujii, Senta; Yang, Shuyu; Chong, Mian‐Yoon; Ungvári, Gábor S.; Si, Tianmei; He, Yan; Chung, Eun Kee; Chee, Kok Yoon; Jk, Trivedi; Udomratn, Pichet; Shinfuku, Naotaka; Kua, Ee Heok; Tan, Chay Hoon; Sartorius, Norman; Baldessarini, Ross J.

doi:10.1017/s1461145711000563

Cited by 29 publications

(29 citation statements)

References 32 publications

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“…The rates of mood stabilizers and sodium valproate use were very similar to those reported in Asia (24% for mood stabilizers and 16.7% for sodium valproate), but lower than those reported in the US, where approximately half of schizophrenic patients received mood stabilizers and about a third received sodium valproate [1], [9], [10], [14]. In the New York State hospital system, in 1996, approximately half of all patients diagnosed with bipolar or schizoaffective disorder and 28% of all patients diagnosed with schizophrenia, were prescribed valproate.…”

Section: Discussionsupporting

confidence: 59%

“…Despite that, the use of mood stabilizers as augmentation therapy for schizophrenic patients has become widespread. The utilization rates of mood stabilizers in patients with schizophrenia range from 15% to almost 50% [1], [10]–[14].…”

Section: Introductionmentioning

confidence: 99%

“…In the past decade, it became the most frequently prescribed mood stabilizer for patients with schizophrenia, with lithium lagging far behind [1], [10], [11], [14].…”

Section: Introductionmentioning

confidence: 99%

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Off-Label Use of Sodium Valproate for Schizophrenia

et al. 2014

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BackgroundOff-label use of a drug not according to its regulatory labeling has become common in medicine, especially in the field of psychiatry. Mood stabilizers are intended to be used to attenuate mood fluctuations in bipolar disorder, but their use has spread to patients with schizophrenia, as it provides greater control of impulsivity and aggressiveness. Sodium valproate is one of the most frequently used mood stabilizers in psychiatry. This study determined the prevalence of off-label use of sodium valproate for schizophrenia and schizoaffective disorder in Abarbanel Psychiatric Hospital and the demographic and clinical characteristics associated with its use.MethodsRetrospective study of patients hospitalized in 2011–2012 with a diagnosis of schizophrenia or schizoaffective disorder in one of three general psychiatric wards.ResultsValproate use was significantly lower in the geriatric group (11.6% vs. 20.1%, chi square = 4.7, p = .03), in patients with schizophrenia (14.1% vs. schizoaffective disorder (35.2%), chi square = 29, p<.001) and in patients receiving both atypical and typical antipsychotics (23.3% vs. 16.4%, p = .04). In multivariate logistic regression analysis, diagnosis and the combination of atypical and typical antipsychotics predicted the use of sodium valproate. The number of other medications prescribed did not predict sodium valproate use.ConclusionsOff-label use of sodium valproate in psychiatric patients with schizophrenia or schizoaffective disorder is extensive, especially in younger patients and those with schizoaffective disorder. More research is needed to determine whether it is being prescribed appropriately.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

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Off-Label Use of Sodium Valproate for Schizophrenia

et al. 2014

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“…Those drugs are used for patients with severe emotional and mood problems. There are multiple reasons for the high rates of combined usage of mood stabilizers in Pakistan and other South Asian countries such as the presence of aggression or irritability, tenacious positive symptoms like delusions, and disorganized speech or as augmentation to antipsychotics that are either poorly tolerated or ineffective [23].…”

Section: Discussionmentioning

confidence: 99%

More than Half of Patients with Schizophrenia Are Receiving Polypharmacy and Co-Prescription of Anxiolytics in Pakistan —Findings from Research on Asian Prescription Pattern in 2016

Malik¹,

Ghani²,

Awais³

et al. 2018

OJPsych

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Objective: Little is known about the prescription pattern of psychotropic drugs for patients with schizophrenia in Pakistan. The purpose of this study was to evaluate the characteristic features of psychotropic drug prescriptions for patients with schizophrenia in Pakistan. Methods: Three centers in Pakistan participated in a large scale collaborative study known as Research on Asian Prescription Pattern (REAP). The 2016 REAP survey included centers from 15 countries in Asia and used a unified research protocol. The design of the study was quantitative and of descriptive epidemiology. Analysis was made on the data collected from three centers i.e., Lahore, Karachi and IslaHow to cite this paper: Malik, M., Ghani, U., Awais, N., Munir, N., Javed, A., Hamirani, M. The main findings of the study were that a majority of the patients were prescribed antipsychotic polypharmacy drugs in Pakistan. Insufficient training on the use of psychotropic drugs and a lack of treatment guideline are considered to be the major contributing factors. Further education and training on the proper use of psychotropic drugs are recommended to psychiatrists in Pakistan. The guidelines on pharmacotherapy for patients with schizophrenia should also be developed and promoted in Pakistan.

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“…Recently, antiepileptics have been used widely as "mood stabilizers" in psychiatric disorders such as schizophrenia and mood disorders as well as epilepsy [152][153][154]. Microglia are suggested to play important roles in these diseases.…”

Section: Discussionmentioning

confidence: 99%

Neurotransmitters, Psychotropic Drugs and Microglia: Clinical Implications for Psychiatry

Kato¹,

Yamauchi²,

Horikawa³

et al. 2013

Current Medicinal Chemistry

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Psychiatric disorders have long and dominantly been regarded to be induced by disturbances of neuronal networks including synapses and neurotransmitters. Thus, the effects of psychotropic drugs such as antipsychotics and antidepressants have been understood to modulate synaptic regulation via receptors and transporters of neurotransmitters such as dopamine and serotonin. Recently, microglia, immunological/inflammatory cells in the brain, have been indicated to have positive links to psychiatric disorders. Positron emission tomography (PET) imaging and postmortem studies have revealed microglial activation in the brain of neuropsychiatric disorders such as schizophrenia, depression and autism. Animal models of neuropsychiatric disorders have revealed the underlying microglial pathologies. In addition, various psychotropic drugs have been suggested to have direct effects on microglia. Until now, the relationship between microglia, neurotransmitters and psychiatric disorders has not been well understood. Therefore, in this review, at first, we summarize recent findings of interaction between microglia and neurotransmitters such as dopamine, serotonin, norepinephrine, acetylcholine and glutamate. Next, we introduce up-to-date knowledge of the effects of psychotropic drugs such as antipsychotics, antidepressants and antiepileptics on microglial modulation. Finally, we propose the possibility that modulating microglia may be a key target in the treatment of various psychiatric disorders. Further investigations and clinical trials should be conducted to clarify this perspective, using animal in vivo studies and imaging studies with human subjects.

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Adjunctive mood stabilizer treatment for hospitalized schizophrenia patients: Asia psychotropic prescription study (2001–2008)

Cited by 29 publications

References 32 publications

Off-Label Use of Sodium Valproate for Schizophrenia

Off-Label Use of Sodium Valproate for Schizophrenia

More than Half of Patients with Schizophrenia Are Receiving Polypharmacy and Co-Prescription of Anxiolytics in Pakistan —Findings from Research on Asian Prescription Pattern in 2016

Neurotransmitters, Psychotropic Drugs and Microglia: Clinical Implications for Psychiatry

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