Coprescription of mood stabilizers in schizophrenia, dosing, and clinical correlates: An international study.

Autor: Lim WK; Institute of Mental Health, Singapore, Singapore., Chew QH; Institute of Mental Health, Singapore, Singapore., He YL; Department of Psychiatric Epidemiology, Shanghai Mental Health Center, Shanghai, China., Si TM; Institute of Mental Health, Peking University, Beijing, China., Chiu FH; Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China., Xiang YT; Faculty of Health Sciences, University of Macau, Macau, China., Kato TA; Department of Neuropsychiatry, Graduate School of Medicine, Kyushu University, Fukuoka, Japan., Kanba S; Department of Neuropsychiatry, Graduate School of Medicine, Kyushu University, Fukuoka, Japan., Shinfuku N; Department of Psychiatry, Kobe University, Kobe, Japan., Lee MS; Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea., Park SC; Department of Psychiatry, Inje University Haeundae Paik Hospital, Busan, South Korea., Park YC; Department of Psychiatry, Hanyang University, Seoul, South Korea., Chong MY; Department of Psychiatry, Kaoshiung Chang Gung Memorial Hospital and Chang Gung University School of Medicine, Kaohsiung, Taiwan., Lin SK; Psychiatric Center, Taipei City Hospital, Taipei, Taiwan., Yang SY; Psychiatric Center, Taipei City Hospital, Taipei, Taiwan., Tripathi A; Department of Psychiatry, King George's Medical University, Lucknow, India., Avasthi A; Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India., Grover S; Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India., Kallivayalil RA; Pushpagiri Institute of Medical Sciences, Tiruvalla, India., Udomratn P; Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand., Chee KY; Department of Psychiatry & Mental Health, Tunku Abdul Rahman Institute of Neurosciences, Kuala Lumpur, Malaysia., Tanra AJ; Department of Psychiatry, Hasanuddin University Faculty of Medicine, Makassar, Indonesia., Rabbani MG; Bangladesh Association of Psychiatrists, Bangladesh, Bangladesh., Javed A; Pakistan Psychiatric Research Center, Fountain House, Lahore, Pakistan., Kathiarachchi S; Department of Psychiatry, University of Sri Jayewardenepura, Nugegoda, Sri Lanka., Waas D; Department of Psychiatry, University of Sri Jayewardenepura, Nugegoda, Sri Lanka., Myint WA; Mental Health Society, Myanmar Medical Association, Yangon, Myanmar., Sartorius N; Association for the Improvement of Mental Health Programmes, Geneva, Switzerland., Tran VC; Vietnam Psychiatric Association (VPA), Hanoi, Vietnam., Nguyen KV; Vietnam Psychiatric Association (VPA), Hanoi, Vietnam., Tan CH; Department of Pharmacology, National University Hospital, Singapore, Singapore., Baldessarini RJ; International Consortium for Mood & Psychotic Disorder Research, McLean Hospital, Belmont, Massachusetts, USA., Sim K; Institute of Mental Health, Singapore, Singapore.
Jazyk: angličtina
Zdroj: Human psychopharmacology [Hum Psychopharmacol] 2020 Nov; Vol. 35 (6), pp. 1-7. Date of Electronic Publication: 2020 Aug 01.
DOI: 10.1002/hup.2752
Abstrakt: Objective: Studies examining coprescription and dosages of mood stabilizers (MSs) with antipsychotics for psychotic disorders are infrequent. Based on sparse extant data and clinical experience, we hypothesized that adjunctive MS use would be associated with certain demographic (e.g., younger age), clinical factors (e.g., longer illness duration), and characteristics of antipsychotic treatment (e.g., multiple or high antipsychotic doses).
Methods: Within an Asian research consortium focusing on pharmaco-epidemiological factors in schizophrenia, we evaluated rates of MS coprescription, including high doses (>1000 mg/day lithium-equivalents) and clinical correlates.
Results: Among 3557 subjects diagnosed with schizophrenia in 14 Asian countries, MSs were coprescribed with antipsychotics in 13.6% (n = 485) of the sample, with 10.9% (n = 53) on a high dose. Adjunctive MS treatment was associated (all p < 0.005) with demographic (female sex and younger age), setting (country and hospitalization), illness (longer duration, more hospitalizations, non-remission of illness, behavioral disorganization, aggression, affective symptoms, and social-occupational dysfunction), and treatment-related factors (higher antipsychotic dose, multiple antipsychotics, higher body mass index, and greater sedation). Patients given high doses of MSs had a less favorable illness course, more behavioral disorganization, poorer functioning, and higher antipsychotic doses.
Conclusions: Schizophrenia patients receiving adjunctive MS treatment in Asian psychiatric centers are more severely ill and less responsive to simpler treatment regimens.
(© 2020 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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