Concurrent antipsychotic use in older adults treated with antidepressants in Asia

Abstract

Aim Depressive disorders are common in old age. Antipsychotics (APs) are often used as an adjunctive treatment with antidepressants (ADs) in this population but its patterns of use in Asia are not known. This study explored the rate of combination of APs and ADs in older adult psychiatric patients in Asia. Methods This is a secondary analysis of the database of a multicentre study which recorded participants’ basic demographical and clinical data in standardised format in 10 Asian countries and territories. The data were analysed using univariate and multivariate logistic regression analyses. Results A total of 955 older adult psychiatric in‐ and outpatients were included in this study. The proportion of concurrent AP and AD use was 32.0%, ranging from 23.3% in Korea to 44.0% in Taiwan. Multivariate logistic regression analysis found that younger age, inpatient status and diagnosis of schizophrenia, anxiety and other mental disorders were significantly related to a higher proportion of concurrent use of APs and ADs. Conclusion Around a third of older adult psychiatric patients had concurrent AP and AD use in the Asian countries/regions surveyed. Considering the uncertain effectiveness and questionable safety of the AP and AD combination in this patient population, such should be cautiously used.

The state of psychiatric research in the Asia Pacific region

“…Other research foci include psychiatric management patterns (Abdul Khaiyom, Mukhtar, & Oei, 2019; Dong et al, 2019; S.‐C. Park, Oh, et al, 2019; Zhong et al, 2019), electroconvulsive therapy, validations of translated scales (C.‐S.…”

Analysis of the trends of polypharmacy and high‐dose prescriptions in Japan

“…In Japan, 140 out of 229 patients (61.1%) received hypnotics. This rate is the highest among all the countries and areas that participated in the survey (Dong, Zeng, Zhang, Ungvari, Ng, Chiu, et al, 2019).…”

“…The DSM‐4 has also been used in countries where the ICD system is not commonly used in clinical practice. The Anatomical Therapeutic Chemical system, developed by the World Health Organization, was used to classify psychotropic drugs prescribed by REAP members (Dong, Zeng, Zhang, Ungvari, Ng, Chiu, et al, 2019; Dong, Zeng, Zhang, Yang, Chen, Najoan, et al, 2019; Dong, Zeng, Zhang, Yang, Chen, Sim, et al, 2019). Each participating country was asked to provide 100–500 prescriptions of patients with schizophrenia, depending on the size of their psychiatric resources.…”

Efficacy and Safety of Traditional Chinese Herbal Medicine for Antipsychotic-Related Constipation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…For example, many people in the central region of China (e.g., Hunan, Hubei, and Jianxi provinces) prefer spicy foods, which could increase the risk of constipation ( 71 ), while those in the eastern region prefer bland foods. The advantage of TCM in terms of remission rate was more obvious in the inpatient group compared to the mixed inpatient and outpatient group, which may be related to better treatment adherence among inpatients ( 72 , 73 ) or due to a small number of studies on mixed patient sample ( n = 2). As expected, meta-regression analysis found that a longer trial duration (β = 0.009, P = 0.013) was associated with a higher remission rate of constipation, probably because the delivery of TCM is more stable in longer studies.…”