Low doses of antipsychotic drugs for hospitalized schizophrenia patients in East Asia: 2004 vs. 2001.

We test the hypothesis of increasing prevalence of low-dose antipsychotic use (300 mg/d chlorpromazine-equivalent) in East Asia and examine clinical correlates of conservative dosing. Rates of low-dose antipsychotic prescription were determined for 4535 patients with DSM-IV diagnosis of schizophrenia in six East Asian countries and territories, with comparisons analysed for 2004 vs. 2001. Between 2001 (n=2399 subjects) and 2004 (n=2136 subjects), prescription rates for low doses of antipsychotic drugs (APDs) increased from 24.8% to 44.0% (p<0.001). Low doses were more likely among older patients (p=0.005), during first-lifetime hospitalizations (p<0.001), and among patients with less prominent delusions, hallucinations or disorganized speech (all p<0.05). Multivariate modelling indicated that low doses were strongly associated with older age, first admission, sampling year (2004>2001), less use of antipsychotic polytherapy (all p<0.001) and depot antipsychotics (p=0.009). Conservative dosing of APDs was increasingly prevalent in East Asia. Our findings suggest characteristics of patients who may be particularly likely to require low antipsychotic doses.

International study on antidepressant prescription pattern at 20 teaching hospitals and major psychiatric institutions in East Asia: Analysis of 1898 cases from China, Japan, Korea, Singapore and Taiwan.

The purpose of the present study was to review the prescription patterns of antidepressants in different countries in East Asia. The survey was conducted in China, Japan, Korea, Singapore and Taiwan from October 2003 to March 2004 using the unified research protocol and questionnaire. Twenty teaching hospitals and major psychiatric hospitals participated and a total of 1898 patients receiving antidepressants were analyzed. The survey provided a number of interesting characteristics on the prescription patterns of antidepressant in East Asia. Out of 56 antidepressants listed in the Anatomical Therapeutic Chemical Classification (ATC) index by the World Health Organization (WHO) Collaborating Center for Drug Statistics Methodology (Oslo), only 26 antidepressants were prescribed in participating countries in East Asia. On average 38.4% of prescriptions of antidepressants were for patients with diagnoses other than depressive disorders. The availability and commonly prescribed antidepressants varied greatly by country. The selective serotonin re-uptake inhibitors (SSRI) and other newer antidepressants were prescribed in approximately 77.0% of all cases. At the time of the survey, only two SSRI medications were available in Japan. However, five types of SSRI were available and were often prescribed in Korea.