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Coprescription of mood stabilizers in schizophrenia, dosing, and clinical correlates: An international study
Author(s) -
Lim Wai Kwong,
Chew Qian Hui,
He YanLing,
Si TianMei,
Chiu FungKum Helen,
Xiang YuTao,
Kato Takahiro A.,
Kanba Shigenobu,
Shinfuku Naotaka,
Lee MinSoo,
Park SeonCheol,
Park YongChon,
Chong MianYoon,
Lin ShihKu,
Yang ShuYu,
Tripathi Adarsh,
Avasthi Ajit,
Grover Sandeep,
Kallivayalil Roy Abraham,
Udomratn Pichet,
Chee Kok Yoon,
Tanra Andi J.,
Rabbani Md Golam,
Javed Afzal,
Kathiarachchi Samudra,
Waas Dulshika,
Myint Wing Aung,
Sartorius Norman,
Tran Van Cuong,
Nguyen Kim Viet,
Tan ChayHoon,
Baldessarini Ross J.,
Sim Kang
Publication year - 2020
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.2752
Subject(s) - antipsychotic , schizophrenia (object oriented programming) , medicine , psychiatry , mood , bipolar disorder , adjunctive treatment , mood disorders , pediatrics , clinical psychology , anxiety
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.