Incident users of antipsychotics: who are they and how do they fare?

Baandrup, Lone; Kruse, Marie

doi:10.1007/s00127-015-1129-8

Cited by 9 publications

(7 citation statements)

References 15 publications

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“…Antipsychotic drugs are approved primarily for the treatment of severe psychiatric disorders, such as schizophrenia and bipolar mania . Furthermore, antipsychotic drugs are also used for a range of other psychiatric disorders, including major depressive disorder, substance abuse, anxiety disorders, sleep disturbance and behavioural symptoms of dementia . However, there is significant variation in the evidence of efficacy for the treatment of these conditions .…”

Section: Introductionmentioning

confidence: 99%

“…However, there is significant variation in the evidence of efficacy for the treatment of these conditions . The overall prevalence of antipsychotic use has been increasing, and population studies have found the use of antipsychotic drugs in non‐psychotic disorders such as depression, anxiety, autism spectrum disorders to be common . In Norway, increasing use of the second‐generation antipsychotic quetiapine was found to coincide with decreasing mean doses and increased prescribing for non‐psychotic disorders, indicating increasing off‐label use .…”

Section: Introductionmentioning

confidence: 99%

“…In Norway, increasing use of the second‐generation antipsychotic quetiapine was found to coincide with decreasing mean doses and increased prescribing for non‐psychotic disorders, indicating increasing off‐label use . Among incident users of antipsychotic drugs in Denmark, the most common psychiatric diagnosis was ‘Reaction to severe stress and adjustment disorders’ followed by major depressive episode and organic mental disorders . Widespread use of antipsychotic drugs might constitute a challenge to public health, as exposure to antipsychotic drugs has been associated with the potential for a range of serious adverse events, ranging from fatal arrhythmias over metabolic disturbances and cardiovascular risk factors to incident diabetes .…”

Section: Introductionmentioning

confidence: 99%

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Trends in utilization and dosing of antipsychotic drugs in Scandinavia: Comparison of 2006 and 2016

Pottegård

Johnsen

Kroken

et al. 2019

Brit J Clinical Pharma

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Aims: The aim of this study was to investigate time trends in dosing and prevalence of antipsychotic prescriptions in Scandinavia.Methods: We retrieved data on antipsychotic use between 2006 and 2016 from Danish, Norwegian and Swedish national prescription registers. For each antipsychotic, we calculated prevalence of use and mean doses, overall and for specific age groups (young, adults and elderly). Results: Antipsychotic use in Scandinavia increased from 16.5 to 17.2 users/1000 inhabitants between 2006 and 2016 (+2.4%, annual change: 0.07 users/1000 inhabitants/year, 95% CI: 0.02-0.20, P = 0.02). In 2006, chlorprothixene and levomepromazine were the most commonly used antipsychotics. By 2016, quetiapine was the most used antipsychotic in all three countries and across all age groups, with an overall 1-year prevalence of 4.05-9.97 users/1000 inhabitants (annual change: 0.57 users/1000 inhabitants/year, 95% CI: 0.54-0.60, P < 0.001). Quetiapine showed a marked decrease in mean doses during the 11-year study period (0.46-0.28 defined daily doses (DDD)/user/day: 39.1%, −0.02 DDD/user/day/year, 95% CI: −0.020 to −0.015, P < 0.001). In 2016, the highest mean doses were seen for clozapine (0.90-1.07 DDD/user/day) and olanzapine (0.66-0.88 DDD/user/day).Conclusions: There is an increased prevalence of antipsychotic prescriptions that coincides with low and/or decreasing mean doses of the majority of commonly used antipsychotics in Scandinavia. Of all antipsychotics, this development was most pronounced for quetiapine. Reasons for and consequences of increased antipsychotic use that lasts shorter periods of time requires further study.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Trends in utilization and dosing of antipsychotic drugs in Scandinavia: Comparison of 2006 and 2016

Pottegård

Johnsen

Kroken

et al. 2019

Brit J Clinical Pharma

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show abstract

“…However, prior drug utilisation studies have found a considerable use of antipsychotics in other psychiatric conditions for which antipsychotics do not have an indication, including dementia, anxiety disorders and insomnia (Marston et al ., 2014 ; Carton et al ., 2015 ; Baandrup and Kruse, 2016 ). Furthermore, antipsychotics are also used in other medical specialties than psychiatry, e.g.…”

Section: Introductionmentioning

confidence: 99%

Use of antipsychotics in Denmark 1997–2018: a nation-wide drug utilisation study with focus on off-label use and associated diagnoses

Andersen

Correll

et al. 2021

Epidemiol Psychiatr Sci

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Aims Antipsychotics are primarily labelled for the treatment of severe mental illness and have documented clinical utility in certain neurological disorders or palliative care. However, off-label use of antipsychotics is common and increasing, and prior studies on antipsychotic utilisation have not specifically assessed users in neurology, palliative care or general practice. We aimed to explore diagnoses associated with antipsychotic use, treatment patterns and characteristics of users without diagnoses relevant to antipsychotic treatment. Methods Population-based study identifiying all users of antipsychotics in Denmark (pop 5.7 mio.) 1997–2018 in the Danish National Prescription Register (DNPR). Possible indications for antipsychotic therapy were evaluated using in- and outpatient contacts from the DNPR. Users were divided hierarchically into six groups: severe mental disorders (schizophrenia, bipolar-spectrum disorders), chronic mental disorders (dementias, mental retardation, autism), other mental disorders (depression-spectrum, anxiety and personality disorders, etc.), selected neurological diseases, cancer and antipsychotic users without any of these diagnoses. This last group was characterised regarding demographics, antipsychotic use, health care utilisation and likely antipsychotic treatment initiator in 2018. Results Altogether, 630 307 antipsychotic users were identified, of whom 127 649 had filled prescriptions during 2018. Users without diagnoses relevant to antipsychotic treatment comprised of the largest group (37%), followed by schizophrenia and bipolar-spectrum disorders (34%), other mental disorders (15%), dementia, autism and mental retardation (11%), cancer (2.2%) and neurological diagnoses (2.0%). Of 37 478 incident users in 2018, 39% had no diagnosis relevant to antipsychotic treatment, 7.9% had major depression, 7.7% neurotic/stress-related disorders and 7.5% dementia. Quetiapine was most commonly used, both overall (51%) and among users without diagnoses relevant to antipsychotic treatment (58%). Of 14 474 incident users in 2018 without diagnoses relevant to antipsychotic treatment, treatment was most likely initiated by a general practitioner (65%), with only 17% seeing a psychiatrist during the following year. As many as 18% of patients with adjustment disorders and 14% of those without relevant diagnoses for antipsychotic use, remained on antipsychotic treatment 5 years after their first prescription. Conclusions Over one-third of antipsychotic users in Denmark did not have psychiatric, neurological or cancer diagnoses as possible indications for antipsychotic therapy. Many antipsychotics are initiated or prescribed in general practice, and a concerningly large subgroup without documented diagnoses relevant for antipsychotics continued to receive them. Rational prescribing, adequate side effect monitoring and further research into reasons for the observed antipsychotic use patterns and their risk–benefit ratio are needed.

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“…El uso de los antipsicóticos en España ha sido descrito junto con su evolución (Carvajal and García del Pozo, 2008). A grandes rasgos, en los últimos años ha aumentado de manera exponencial el consumo de estas sustancias, por otra parte, la utilización de antipsicóticos típicos, de primera generación, ha sido sustituida por la utilización de los antipsicóticos atípicos o de segunda generación; este también ha sido el patrón a nivel internacional (Baandrup and Kruse, 2015). En el estudio de seguimiento que se ha llevado a cabo, se confirmó con mayor detalle ese patrón de consumo preferente de antipsicóticos atípicos; el antipsicótico más utilizado ha sido la risperidona, seguido de la quetiapina, olanzapina y aripiprazol.…”

Section: Utilización De Antipsicóticosunclassified

Determinantes del aumento de peso producido por los antipsicóticos: un estudio de cohortes

González¹

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Incident users of antipsychotics: who are they and how do they fare?

Cited by 9 publications

References 15 publications

Trends in utilization and dosing of antipsychotic drugs in Scandinavia: Comparison of 2006 and 2016

Trends in utilization and dosing of antipsychotic drugs in Scandinavia: Comparison of 2006 and 2016

Use of antipsychotics in Denmark 1997–2018: a nation-wide drug utilisation study with focus on off-label use and associated diagnoses

Determinantes del aumento de peso producido por los antipsicóticos: un estudio de cohortes

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