International variation in antipsychotic prescribing for schizophrenia: Pooled results from the research on East Asia psychotropic prescription (reap) studies

Hiroto Ito, Yasuyuki Okumura, Teruhiko Higuchi, Chay Hoon Tan, Naotaka Shinfuku

Department of Social Psychiatry, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
National Center of Neurology and Psychiatry, Tokyo, Japan.
National University of Singapore, Singapore City, Singapore.
School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan.

DOI: 10.4236/ojpsych.2012.224048                

Abstract

Objective: To identify updated trends in antipsychotic prescribing patterns in patients with schizophrenia in East Asia. Methods: Using the data from the 2001, 2004, and 2008 Research on East Asia Psychotropic Prescription (REAP) studies, we compared the proportions of acute inpatients (stay <6 months), new long-stay patients (6 months to 3 years), and old long-stay patients (≥3 years), the rates of excessive dosing (more than chlorpromazine 1,000 mg equivalent) and polypharmacy (the coprescription of more than 1 antipsychotic). Findings: While the proportion of long-term inpatients increased over time in Chinese mainland and Taiwan, it decreased in Japan, Singapore and Hong Kong. The proportion of acute inpatients receiving more than one drug was highest in Singapore, followed by Japan, Korea and Chinese Mainland. Two-drug combination therapy was especially high in Singapore. Korea had the highest rate of excessive dosing followed by Japan and Hong Kong. While the rates of both polypharmacy and excessive dosing decreased significantly over time in Japan, polypharmacy increased significantly in Chinese Mainland and Taiwan and excessive dosing increased significantly in Korea and Hong Kong. Conclusion: Our results suggest that the change in antipsychotic prescribing patterns, including excessive dosing and polypharmacy, varied among the participating East Asian countries/areas.

Keywords

Antipsychotic; East Asia; Polypharmacy; Schizophrenia

Conflicts of Interest

The authors declare no conflicts of interest.

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