Original Research
Antipsychotic treatment in older schizophrenia patients with extrapyramidal side effects in Asia (2001 – 2009)
Yu-Tao Xiang, Julie Kreyenbuhl, Faith B. Dickerson, Gabor S. Ungvari, Chuan‑Yue Wang, Tian-Mei Si, Edwin H.M. Lee, Helen F.K. Chiu, Kelly Y. C. Lai, Yan-Ling He, Shu-Yu Yang, Mian-Yoon Chong, Chay-Hoon Tan, Ee‑Heok Kua, Senta Fujii, Kang Sim, Michael K.H. Yong, Jitendra K. Trivedi, Eun‑Kee Chung, Pichet Udomratn, Kok- Yoon Chee, Norman Sartorius and Naotaka Shinfuku
Price
42.00 $
Volume 50 p. 500 - 504
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 50 – No. 7/2012 (500-504)
Antipsychotic treatment in older schizophrenia patients with extrapyramidal side effects in Asia (2001 – 2009)
Yu-Tao Xiang1,2, Julie Kreyenbuhl3,4, Faith B. Dickerson5, Gabor S. Ungvari6, Chuan‑Yue Wang2, Tian-Mei Si7, Edwin H.M. Lee1, Helen F.K. Chiu1, Kelly Y. C. Lai1, Yan-Ling He8, Shu-Yu Yang9, Mian-Yoon Chong10, Chay-Hoon Tan11, Ee‑Heok Kua11, Senta Fujii12, Kang Sim13, Michael K.H. Yong13, Jitendra K. Trivedi14, Eun‑Kee Chung15, Pichet Udomratn16, Kok-Yoon Chee17, Norman Sartorius18 and Naotaka Shinfuku19
1Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, 2Beijing Anding Hospital, Capital Medical University, Beijing, China, 3Division of Services Research, Department of Psychiatry, University of Maryland School of Medicine, 4Veterans Administration Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), 5The Stanley Research Program at Sheppard Pratt, Baltimore, MD, USA, 6School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia, 7Key Laboratory of Mental Health, Ministry of Mental Health & Peking University Institute of Mental Health, Beijing, 8Shanghai Mental Health Center, Shanghai, China, 9Taipei City Hospital, Taipei, 10Kaohsiung Chang Gung Memorial Hospital and School of Medicine, Chang Gung University, Taiwan, 11National University of Singapore, Singapore, 12Hyogo Institute for Traumatic Stress (HITS), Kobe, Japan, 13Institute of Mental Health, Buangkok View, Singapore, 14Department of Psychiatry, C.S.M.Medical University UP, Lucknow, Uttar Pradesh, India, 15National Seoul Hospital, Seoul, Korea, 16Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand, 17Department of Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neuroscience, Kuala Lumpur Hospital, Malaysia, 18Association for the Improvement of Mental Health Programs, Geneva, Switzerland and 19School of Human Sciences, Seinan Gakuin University Fukuoka, Japan
Kaohsiung Chang Gung Memorial Hospital and School of Medicine, Chang Gung University, Taiwan, National University of Singapore, Singapore, Hyogo Institute for Traumatic Stress (HITS), Kobe, Japan, Institute of Mental Health, Buangkok View,
Singapore, Department of Psychiatry, C.S.M.Medical University UP, Lucknow, Uttar
Pradesh, India, National Seoul Hospital, Seoul, Korea, Department of Psychiatry,
Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand, Department of
Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neuroscience, Kuala Lumpur Hospital, Malaysia, Association for the Improvement of Mental Health Programs, Geneva, Switzerland and School of Human Sciences, Seinan Gakuin University Fukuoka, Japan
Objective: This study surveyed the prescribing patterns of antipsychotic medications in Asian older schizophrenia patients with extrapyramidal side effects (EPS) during the period between 2001 and 2009. Method: Information on 848 hospitalized patients with schizophrenia aged 60 or older was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study (2001 – 2009). Data from those patients with reported EPS from 8 Asian countries and territories including China, Hong Kong, Japan, Korea, Singapore, Taiwan, India and Malaysia were analyzed. The cross-sectional data of sociodemographic and clinical characteristics and antipsychotic prescriptions were collected using a standardized protocol and data collection procedure. Results: Of the 309/848 (36%) patients suffering from EPS, 210 patients (210/309; 68.0%) received at least one type of first generation antipsychotic (FGA), and 99 (99/309; 32.0%) received second generation antipsychotics (SGAs) only. Of SGAs prescribed in patients with EPS, risperidone was the most commonly used (100/309; 32.4%) followed by olanzapine (33/309; 10.7%) and quetiapine (25/309; 8.1%). Conclusions: FGAs were frequently used in Asian older schizophrenia patients with EPS. Considering the potential adverse effects of FGAs on existing EPS, the reasons for the frequent use of FGAs need to be urgently identified.Correspondence to:
Dr. Yu-Tao Xiang
Department of Psychiatry
Chinese University of Hong Kong
Ground Floor, Multicentre, Tai Po Hospital
Tai Po, N.T., Hong Kong, China
Email: [email protected]
Original Research
Prescription patterns of psychotropic medications and use of electroconvulsive therapy in Chinese patients with dementia
Lu Li, Zhi-Min Wang, Helen F.K. Chiu, Gabor S. Ungvari, Chee H. Ng, Ada W.Y. Tse, Grace K.I. Lok, Jian-Song Zhou, and Yu-Tao Xiang
Price
42.00 $
Volume 53 p. 722 - 727
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 53 – No. 9/2015 (722-727)
Prescription patterns of psychotropic medications and use of electroconvulsive therapy in Chinese patients with dementia
Lu Li1, Zhi-Min Wang2, Helen F.K. Chiu3, Gabor S. Ungvari4,5, Chee H. Ng6, Ada W.Y. Tse3, Grace K.I. Lok7, Jian-Song Zhou8, and Yu-Tao Xiang1,2
1Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, 2Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, 3Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China, 4The University of Notre Dame Australia / Marian Center, 5School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, 6Department of Psychiatry, University of Melbourne, Melbourne, Australia, 7Kiang Wu Nursing College of Macau, Macao SRA, and 8Mental Health Institute of the Second Xiangya Hospital, Central South University, Hunan and Key Laboratory of Psychiatry and Mental Health of Hunan Province, China
Background: Little is known about psychiatric pharmacotherapy and somatic treatments in dementia in China. This study examined the prescription patterns of psychotropic medications and use of electroconvulsive therapy (ECT) in dementia patients hospitalized in a psychiatric institution in Beijing, China. Methods: This was a retrospective chart review of 401 patients with dementia treated over a period of 7 years (2007 – 2013) in a university-affiliated psychiatric institution in Beijing. Socio-demographic and clinical data were collected from the electronic chart management system (ECMS) for discharged patients. Results: Nearly all patients (96.8%) received psychotropic medications in order of frequency: second-generation antipsychotics (83.0%), benzodiazepines (77.8%), first generation antipsychotics (39.7%), antidepressants (29.7%), and mood stabilizers (24.7%). The rate of polypharmacy and ECT use was 82.0% and 3.7%, respectively. Prescription of mood stabilizers was associated with longer length of hospitalization. Conclusions: In a major psychiatric hospital in China, ECT was sporadically used in patients with dementia, while the vast majority of patients received at least one type of psychotropic medication. Factors contributing to the high use of psychopharmacological interventions in this population warrant further investigations.Correspondence to:
Dr. Zhi-Min Wang
Mood Disorders Center, Beijing Anding Hospital, China
or
Dr. Yu-Tao Xiang
3/F, Building E12, Faculty of Health Sciences
University of Macau, Avenida da Universidade
Taipa, Macau SAR, China
Email: [email protected] or [email protected]
Original
Antipsychotic polypharmacy and quality of life in patients with schizophrenia treated in primary care in China
Cai-Lan Hou, Xin-Rong Ma, Yu Zang, Fu-Jun Jia, Yong-Qiang Lin, Helen F.K. Chiu, Gabor S. Ungvari, Chee H. Ng, Bao-Liang Zhong, Xiao-Lan Cao, Yan Li, Mei-Ying Cai, and Yu-Tao Xiang
Price
42.00 $
Volume 54 p. 36 - 42
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 54 – No. 1/2016 (36-42)
Antipsychotic polypharmacy and quality of life in patients with schizophrenia treated in primary care in China
Cai-Lan Hou1*, Xin-Rong Ma2,3*, Yu Zang4*, Fu-Jun Jia1, Yong-Qiang Lin1, Helen F.K. Chiu5, Gabor S. Ungvari6, Chee H. Ng7, Bao-Liang Zhong5, Xiao-Lan Cao4, Yan Li5, Mei-Ying Cai8, and Yu-Tao Xiang9
1Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, 2Southern Medical University, Guangdong Province, 3Ningxia Mental Health Center, Ningxia Ning-An Hospital, Ningxia Province, 4Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, 5Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China, 6School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, 7Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia, and 8Guangzhou Yuexiu Center for Disease Control and Prevention, Guangdong Province, and 9Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
Objective: In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians, but their prescribing patterns have not been studied. This study examined the frequency as well as demographic and clinical correlates of antipsychotic polypharmacy (APP) and its impact on quality of life (QOL) in patients with schizophrenia treated in primary care in China. Method: A total of 623 community-dwelling patients from 18 randomly selected primary care services were interviewed. Patients’ socio-demographic and clinical characteristics, including number of hospitalizations, antipsychotic drug-induced side effects, and QOL were recorded using a standardized protocol and data collection procedure. Results: The rate of APP prescription was 31% (193/623). Of the patients on APP, 89.6% received 2 antipsychotics, 10.4% received 3 or more antipsychotics. Clozapine (35.6%) was the most commonly prescribed second generation antipsychotic (SGA), while perphenazine (17.8%) was the most commonly prescribed first generation antipsychotic (FGA). Multiple logistic regression analyses revealed that patients on APP were more likely to receive SGAs and anticholinergics, had fewer hospitalizations, younger age of onset, and higher doses of antipsychotics. There were no significant differences between the two groups in any of the QOL domains. Conclusions: Approximately a third of Chinese patients with schizophrenia in primary care receive APP. Further examination of the rationale and appropriateness of APP and its alternatives is warranted.
*These authors contributed equally to the paper.Correspondence to:
Dr. Fu-Jun Jia
Guang Dong Mental Health Centre
Guangdong province, China
or
Dr. Yu-Tao Xiang
3/F, Building E12
Faculty of Health Sciences, University of Macau
Avenida da Universidade, Taipa, Macau SAR, China
Email: [email protected]; or [email protected]
Original Research
Prevalence of overweight in schizophrenia patients in Asia: findings of the research on Asian psychotropic prescription patterns (REAP) study
Fei Wang, Yu-Tao Xiang, Gabor S. Ungvari, Chee H. Ng, Helen F.K. Chiu, Wei Zheng, Chay-Hoon Tan, and Naotaka Shinfuku
Price
42.00 $
Volume 54 p. 450 - 455
Abstract
International Journal of Clinical Pharmacology and Therapeutics, Vol. 54 – No. 6/2016 (450-454)
Prevalence of overweight in schizophrenia patients in Asia: findings of the research on Asian psychotropic prescription patterns (REAP) study
Fei Wang1, Yu-Tao Xiang1, Gabor S. Ungvari2,3, Chee H. Ng4, Helen F.K. Chiu5, Wei Zheng6, Chay-Hoon Tan7, and Naotaka Shinfuku8
1Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China, 2School of Psychiatry & Clinical Neurosciences, University of Western Australia, 3University of Notre Dame Australia/Marian Center, Perth, 4Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia, 5Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, 6Guangzhou Brain Hospital (Guangzhou Huiai Hospital), Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China, 7Department of Pharmacology, National University of Singapore, Singapore, and 8International Center for Medical Research, Kobe University School of Medicine, Kobe, Japan
Objective: This study examined the proportion of overweight in schizophrenia inpatients in selected Asian countries and territories and its independent demographic and clinical correlates. Method: Data on 1,534 hospitalized schizophrenia patients in 9 Asian countries and territories were collected by a review of medical files supplemented by a clinical interview during a 1-month period. Patients’ sociodemographic and clinical characteristics, prescriptions of psychotropic drugs, and Body Mass Index (BMI) were recorded using a standardized protocol and data collection procedure. For analyzes, BMI ≥ 25 kg/m2 was defined as overweight. Results: The proportion of overweight was 35.8% (549/1,534) in the entire sample, with 39.7% (224/564) in females and 33.5% (325/970) in males (p = 0.01) and with wide inter-country variations. Multiple logistic regression analysis revealed that after controlling for study sites, overweight was independently associated with more frequent use of mood stabilizers (p < 0.001, odds ration (OR) = 1.4, 95% confidence interval (CI) = 1.1 – 1.8) and longer length of illness (p < 0.001, OR = 1.6, 95% CI = 1.2 – 2.1) but was less likely found in male patients (p = 0.003, OR = 0.7, 95% CI = 0.5 – 0.8). Conclusions: The prevalence of overweight Asian schizophrenia patients is significantly lower than the reported figures among their Western counterparts. There is considerable variation in prevalence of overweight schizophrenia patients within Asian countries and territories.Correspondence to:
Dr. Yu-Tao Xiang, MD, PhD
3/F, Building E12, Faculty of Health Sciences
University of Macau
Avenida da Universidade, Taipa, Macau SAR, China
Email: [email protected]
