Pharmacopsychiatry 2012; 45(01): 7-12
DOI: 10.1055/s-0031-1286345
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Antipsychotic Polypharmacy in Inpatients with Schizophrenia in Asia (2001−2009)

Y.-T. Xiang
1  Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, P. R. China
2  Beijing Anding Hospital, Capital Medical University, Beijing, P. R. China
,
C.-Y. Wang
2  Beijing Anding Hospital, Capital Medical University, Beijing, P. R. China
,
T.-M. Si
3  Peking University, Institute of Mental Health, Beijing, P. R. China
,
E.H. M. Lee
1  Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, P. R. China
,
Y.-L. He
4  Shanghai Mental Health Center, Shanghai, P. R. China
,
G. S. Ungvari
5  The University of Notre Dame Australia, Marian Centre, Perth, Australia
,
H.F. K. Chiu
1  Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, P. R. China
,
S.-Y. Yang
6  Taipei City Hospital, Taipei, Taiwan, ROC
,
M.-Y. Chong
7  Kaohsiung Chang Gung Memorial Hospital and School of Medicine, Chang Gung University, Taiwan, ROC
,
C.-H. Tan
8  National University of Singapore, Singapore
,
E.-H. Kua
8  National University of Singapore, Singapore
,
S. Fujii
9  Hyogo Institute for Traumatic Stress (HITS), Kobe, Japan
,
K. Sim
10  Institute of Mental Health, Buangkok View, Singapore, Singapore
,
K. H. Yong
10  Institute of Mental Health, Buangkok View, Singapore, Singapore
,
J. K. Trivedi
11  Department of Psychiatry, C. S. M. Medical University UP, Lucknow, Uttar Pradesh, India
,
E.-K. Chung
12  National Seoul Hospital, Seoul, Korea
,
P. Udomratn
13  Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
,
K.-Y. Chee
14  Department of Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neuroscience, Kuala Lumpur Hospital, Malaysia
,
N. Sartorius
15  Association for the Improvement of Mental Health Programs, Geneva, Switzerland
,
N. Shinfuku
16  School of Human Sciences, Seinan Gakuin University Fukuoka, Japan
› Author Affiliations
Further Information

Publication History

received 01 May 2011
revised 01 July 2011

accepted 29 July 2011

Publication Date:
11 October 2011 (online)

Abstract

Objective:

This study aimed to identify trends in the use of antipsychotic polypharmacy (APP) and their demographic and clinical correlates in the treatment of schizophrenia in Asia between 2001 and 2009.

Method:

A total of 6761 schizophrenia inpatients in 9 Asian countries and territories were examined; 2399 in 2001, 2136 in 2004, and 2226 in 2009. Patients’ socio-demographic and clinical characteristics and prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure.

Results:

The proportion of APP prescription decreased from 46.8% in 2001, to 38.3% in 2004, and increased to 43.4% in 2009, with wide inter-country variations at each survey. Multiple logistic regression analysis of the whole sample revealed that patients on APP were younger, had a higher dose of antipsychotics in chlorpromazine equivalents, and more severe positive and negative symptoms. They were also more likely to receive depot and first-generation antipsychotic drugs.

Conclusions:

The frequency of APP prescription varied between countries and territories, suggesting that a host of clinical and socio-cultural factors played a role in determining APP use in Asia. To resolve the discrepancy between treatment recommendation and clinical practice, regular reviews of prescription patterns are needed.