Clin Psychopharmacol Neurosci.  2015 Dec;13(3):275-282. 10.9758/cpn.2015.13.3.275.

Antipsychotic Prescribing Patterns in First-episode Schizophrenia: A Five-year Comparison

Affiliations
  • 1Department of Psychiatry, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
  • 2Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. spr88@yuhs.ac
  • 3Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.

Abstract


OBJECTIVE
Early treatment choice is critical in first-episode schizophrenia-spectrum disorders. The purpose of this study was to describe prescribing trends of antipsychotics use in patients with first-episode schizophrenia in 2005 and 2010, respectively.
METHODS
We reviewed the medical records of newly treated patients with schizophrenia from a university psychiatric hospital in 2005 (n=47) and 2010 (n=52). We defined patients as receiving a high antipsychotic dose if their ratio of prescribed daily dose (PDD) to defined daily dose (DDD) was greater than 1.5.
RESULTS
The rates of high-dose antipsychotic prescription were 61.7% and 53.8% in 2005 and 2010, respectively. The rates of antipsychotic polypharmacy were 34.6% in 2005 and 34.0% in 2010. The most common first-prescribed antipsychotics were (in descending order of prescription frequency) olanzapine, risperidone, aripiprazole, and haloperidol in 2005 and risperidone, quetiapine, paliperidone, and olanzapine in 2010. High-dose antipsychotics were significantly associated with antipsychotic poly-pharmacy (odds ratio=23.97; p<0.01). More individuals were treated with mood stabilizers in 2010 than in 2005 (p=0.003).
CONCLUSION
The practice of prescribing high-dose antipsychotics and associated antipsychotic polypharmacy were common even for initial treatment of first-episode schizophrenia in 2005 and 2010. In 2010, the list of the most common first-prescribed antipsychotics changed, and the use of mood stabilizers increased in non-affective schizophrenia.

Keyword

Schizophrenia; Antipsychotic agents; Polypharmacy; First-episode; Antimanic agents
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