Prescription profiles for pharmacological treatment of Japanese inpatients with schizophrenia: comparison between 2007 and 2009

Yoshino, Takashi; Inada, Toshiya; Uno, Junji; Miwa, Takaichi; Kitagawa, Keisuke; Miyahara, Y.; Umeda, Kenta; Kato, Tsuyoshi; Inagaki, Ataru; Nabeshima, Toshitaka

doi:10.1002/hup.1272

Cited by 26 publications

(26 citation statements)

References 19 publications

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“…APP rates are relatively high, with reported prevalence of around 10% to 50% (Broekema et al, 2007; Brunot et al, 2002; Clark et al, 2002; Correll et al, 2007; Faries et al, 2005; Fourrier et al, 2000; Ganguly et al, 2004; Jaffe and Levine, 2003; Kreyenbuhl et al, 2006; Procyshyn et al, 2001; Sim et al, 2004; Tapp et al, 2003; Wang et al, 2000). The APP rate in Japan is reported to be even higher (Ito et al, 1999), with a more recent inpatient survey indicating that 66.2% of them were taking 2 or more antipsychotics (Yoshio et al, 2012). According to recent meta-analysis, APP prevalence and time trends differ by region.…”

Section: Introductionmentioning

confidence: 99%

Antipsychotic polypharmacy: A Japanese survey of prescribers' attitudes and rationales

Kishimoto

Watanabe

Uchida

et al. 2013

Psychiatry Research

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While combining antipsychotics is common in schizophrenia treatment, the literature on the reasons for antipsychotic polypharmacy (APP) is limited. We aimed to identify prescriber attitudes and rationales for APP in Japan where high APP utilization is reported. Two-hundred-seventeen psychiatrists participated in the survey, which assessed APP attitudes and behaviors. Prescribing APP to 47.7±24.7% (mean±SD) of their patients, psychiatrists reported that they were “moderately” concerned about APP. The most APP-justifiable factors were (1=“not at all” to 5=“extreme”): cross titration (4.50±0.67), randomized controlled evidence (3.67±0.83), and treatment of comorbid conditions (3.31±0.83). Conversely, APP-discouraging factors were: chronic side effects (4.14±0.64), difficulty determining cause and effect (4.07±0.74), and acute side effects (3.99±0.81). Comparing high to low APP prescribers (>50% vs. ≤50% of patients), no differences emerged regarding APP justification and concerns. In multivariate analyses, high APP use was associated with practice at a psychiatric hospital (OR: 2.70, 95%CI: 1.29-5.67, p=0.009), concern about potential drug-drug interactions (OR: 1.56, 95%CI: 1.04-2.35, p=0.031), and less reliance on case reports of APP showing efficacy (OR: 0.64, 95%CI: 0.44-0.92, p=0.017) (r2=0.111, p=0.001). High and low APP prescribers shared a comparable degree of justifications and concerns. Future research should examine the impact of cultural determinants on APP.

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Section: Introductionmentioning

confidence: 99%

Antipsychotic polypharmacy: A Japanese survey of prescribers' attitudes and rationales

Kishimoto

Watanabe

Uchida

et al. 2013

Psychiatry Research

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“…There are many reports in the literature on the association between xerostomia and antipsychotic drugs, and a strong association between the use of psychotropic drugs and xerostomia in schizophrenia patients has been observed . The use of multiple psychotropic drugs, along with added antiparkinsonian drugs for the treatment of side effects, is also suggested to cause xerostomia …”

Section: What Is Known and Objectivementioning

confidence: 99%

Relationship between xerostomia and psychotropic drugs in patients with schizophrenia: evaluation using an oral moisture meter

et al. 2016

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“…The use of long‐term anticholinergics with antipsychotics is still highly prevalent in Japan . Yoshio et al .…”

Section: Effect Of Discontinuation Of Long‐term Anticholinergic Use Omentioning

confidence: 99%

“…Thus, current treatment guidelines for schizophrenia generally do not recommend the prophylactic and chronic use of anticholinergics . However, the high use of long‐term anticholinergic drugs with antipsychotics has been identified as an important issue in the treatment of schizophrenia in several countries …”

mentioning

confidence: 99%

Benefits and limits of anticholinergic use in schizophrenia: Focusing on its effect on cognitive function

Ogino

Miyamoto

Miyake

et al. 2013

Psychiatry Clin Neurosci

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All currently available antipsychotic drugs are the dopamine D2 receptor antagonists and are capable of producing extrapyramidal side-effects (EPS). Anticholinergic drugs are primarily used to treat EPS or prevent EPS induced by antipsychotics in the treatment of psychosis and schizophrenia. However, they can cause a variety of distressing peripheral sideeffects (e.g. dry mouth, urinary disturbances, and constipation) and central adverse effects (e.g. cognitive impairment, worsening of tardive dyskinesia, and delirium). Disturbances in cognitive abilities are cardinal features of schizophrenia from its earliest phases and account for much of the functional disability associated with the illness. It is likely that long-term concomitant administration of anticholinergics exacerbates the underlying cognitive impairment in patients with schizophrenia and subsequently affects patients' quality of life. Thus, current treatment guidelines for schizophrenia generally do not recommend the prophylactic and long-term use of anticholinergics. However, the high use of long-term anticholinergic drugs with antipsychotics has been identified as an important issue in the treatment of schizophrenia in several countries. To assess the benefits and limits of anticholinergic use in psychosis and schizophrenia, this article will provide a brief review of the pharmacology and clinical profiles of anticholinergic drugs and will focus on their effects on cognitive function in schizophrenia, particularly during the course of the early phase of the illness. In addition, we will address the effects of discontinuation of anticholinergics on cognitive function in patients with schizophrenia and provide a strategy for adjunctive anticholinergic use in patients treated with long-acting injectable antipsychotics.

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Prescription profiles for pharmacological treatment of Japanese inpatients with schizophrenia: comparison between 2007 and 2009

Cited by 26 publications

References 19 publications

Antipsychotic polypharmacy: A Japanese survey of prescribers' attitudes and rationales

Antipsychotic polypharmacy: A Japanese survey of prescribers' attitudes and rationales

Relationship between xerostomia and psychotropic drugs in patients with schizophrenia: evaluation using an oral moisture meter

Benefits and limits of anticholinergic use in schizophrenia: Focusing on its effect on cognitive function

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