Prescribing Trends for the Same Patients with Schizophrenia Over 20 Years

Norio Yasui-Furukori,1,2 Yasushi Kawamata,1,3 Taro Sasaki,1,4 Saaya Yokoyama,1,5 Hiroaki Okayasu,1,6 Masataka Shinozaki,1,7 Yoshitaka Takeuchi,1,8 Aoi Sato,1,9 Takaaki Ishikawa,1,10 Hazuki Komahashi-Sasaki,1,11 Kensuke Miyazaki,12 Takashi Fukasawa,13 Hanako Furukori,14 Norio Sugawara,1,2 Kazutaka Shimoda1 1Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan; 2Department of Psychiatry, TMC Shimotsuga, Tochigi, Japan; 3Department of Psychiatry, Kikuchi Hospital, Tochigi, Japan; 4Department of Psychiatry, Asahi Hospital, Tochigi, Japan; 5Department of Psychiatry, Aoki Hospital, Tochigi, Japan; 6Department of Psychiatry, Fudogaoka Hospital, Saitama, Japan; 7Department of Psychiatry, Takizawa Hospital, Tochigi, Japan; 8Department of Psychiatry, Okamotodai Hospital, Tochigi, Japan; 9Department of Psychiatry, Muroi Hospital, Tochigi, Japan; 10Department of Psychiatry, Saitama-Konan Hospital, Saitama, Japan; 11Department of Psychiatry, Kanuma Hospital, Tochigi, Japan; 12Department of Neuropsychiatry, Hirosaki-Aiseikai Hospital, Aomori, Japan; 13Department of Psychiatry, Seinan Hospital, Aomori, Japan; 14Department of Neuropsychiatry, Kuroichi-Akebono Hospital, Aomori, JapanCorrespondence: Norio Yasui-Furukori, Department of Psychiatry, Dokkyo Medical University, School of Medicine, Mibu, Shimotsuga, Tochigi, 321-0293, Japan, Tel +81-282-86-1111, Fax +81-282-86-5187, Email furukori@dokkyomed.ac.jpBackground: Recent pharmacoepidemiology data show an increase in the proportion of patients receiving second-generation antipsychotic (SGA) monotherapy, but no studies have analyzed the same patients over a long period of time. Therefore, in this study, we retrospectively evaluated schizophrenia patients with available data for 20 years to determine whether the drug treatments in the same patients have changed in the past 20 years.Methods: The study began in April 2021 and was conducted in 15 psychiatric hospitals in Japan. Schizophrenia patients treated in the same hospital for 20 years were retrospectively examined for all prescriptions in 2016, 2011, 2006, and 2001 (ie, every 5 years).Results: The mean age of the 716 patients surveyed in 2021 was 61.7 years, with 49.0% being female. The rate of antipsychotic monotherapy use showed a slight increasing trend over the past 20 years; the rate of SGA use showed a marked increasing trend from 28.9% to 70.3% over the past 20 years, while the rate of SGA monotherapy use showed a gradual increasing trend over the past 20 years. The rates of concomitant use of anticholinergics, antidepressants, anxiolytics/sleep medications, and mood stabilizers showed decreasing, flat, flat, and flat trends over the past 20 years, respectively.Conclusion: The results of this study showed a slow but steady substitution of SGAs for first-generation antipsychotics (FGAs) over time, even in the same patients.Keywords: pharmacoepidemiology, prescription, antipsychotics, trends, schizophrenia