Past Issues
Changing Patterns of Antipsychotic Prescription and Concomitant Antiparkinson Drug Use at a Taiwanese Psychiatric Hospital
Yu-Hsuan Wu, Mei-Feng Huang, Chun-Yang Lai, Yu-Hui Huang, Yu-San Chang
Objectives:This study was intended to investigate the prescribing patterns of
antipsychotic drugs in hospitalized schizophrenia patients receiving antiparkinson
drugs (APDs) at a psychiatric hospital in Taiwan from 2007 to 2011, and to analyze
co-prescribing rates of APDs of each antipsychotic drug. Methods:We collected
patients’ demographic data including information of admission year, age, gender,
and length of hospital stay, and their drug-related information. Results:The five-
year trend of long-term prescriptions of antipsychotic drugs showed that use of first-
generation antipsychotic drugs (FGAs) was decreased, and the use of second-gener-
ation antipsychotic drugs (SGAs) was increased. There were 38.7% of the patients
receiving antipsychotic polypharmacy, and the rate was highest in those receiving a
combination of FGAs and SGAs. Over the study period, the co-prescribing APDs
was decreased by 15%. A longer hospital stay (p< 0.001) and using a higher than
recommended dose of antipsychotic drugs (p< 0.001) were found to significantly
increase a greater risk of co-prescribing APDs. Among the FGAs, haloperidol (p<
0.001) and trifluoperazine (p< 0.05) were found to be associated with a significantly
higher risk of co-prescribing APDs; chlorpromazine (p< 0.001) and sulpiride (p<
0.001) were found to be associated with a significantly lower risk of co-prescribing
APDs. Among the SGAs, amisulpride (p< 0.001), risperidone (p< 0.001), and zot-
epine (p< 0.001) were associated with a significantly higher risk of co-prescribing
APDs; clozapine (p< 0.001), olanzapine (p< 0.05), and quetiapine (p< 0.001) were
associated with a significantly lower risk of co-prescribing APDs. Conclusion:The
availability of SGAs had been increased in recent years. The SGAs are not a homog-
enous group of antipsychotic drugs for the risk potential of extrapyramidal symp-
toms (EPS). Having a considerably high rate of EPS possible associated with some
SGAs warrants clinical attention.
Key Word | first-generation antipsychotic drugs, second-generation antipsychotic drugs, schizophrenia, antiparkinson drugs |
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