Change of prescription for patients with schizophrenia or major depressive disorder during admission: real-world prescribing surveys from the effectiveness of guidelines for dissemination and education psychiatric treatment project.

Publication date: Jun 28, 2023

Polypharmacy of additional psychotropics alongside the main treatment drug (antipsychotics in schizophrenia and antidepressants in major depressive disorder) is common in Japan. Our goal is to align psychotropic prescription in Japan with international standards, while reducing the differences between facilities. To achieve this goal, we aimed to compare prescriptions at the time of hospital admission and discharge. Data on prescriptions at admission and discharge from 2016 to 2020 were collected. We divided the patients into four groups: (1) mono_mono group, monotherapy of the main drug at admission and discharge; (2) mono_poly group, monotherapy at admission and polypharmacy at discharge; (3) poly_poly group, polypharmacy at admission and discharge; and (4) poly_mono group, polypharmacy at admission and monotherapy at discharge. We compared the changes in dosage and number of psychotropics among the four groups. For both schizophrenia and major depressive disorder, the patients who received monotherapy with the main drug at admission were likely to receive main drug monotherapy at discharge and vice versa. For schizophrenia, the polypharmacy was prescribed more often in the mono_poly group than that in the mono_mono group. The prescription was not changed at all for more than 10% of the patients. It is critical to avoid a polypharmacy regimen to ensure that guideline-compliant treatment is provided. We expect higher rates of monotherapy with the main drug after the EGUIDE lectures. The study protocol was registered in the University Hospital Medical Information Network Registry (UMIN000022645).

Open Access PDF

Concepts Keywords
Goal Antidepressants
Japan Antipsychotics
Lectures Monotherapy
Psychiatry Polypharmacy
Umin000022645 Psychotropics


Type Source Name
disease MESH schizophrenia
disease MESH major depressive disorder
pathway REACTOME Reproduction
drug DRUGBANK Sulpiride
drug DRUGBANK Clonazepam
drug DRUGBANK Chlorpromazine
drug DRUGBANK Promethazine
drug DRUGBANK Phenobarbital
drug DRUGBANK Calcium
drug DRUGBANK Acetazolamide
drug DRUGBANK Cyanamide
drug DRUGBANK Diphenhydramine
drug DRUGBANK Donepezil
drug DRUGBANK Gabapentin enacarbil
drug DRUGBANK Galantamine
drug DRUGBANK Guanfacine
drug DRUGBANK Lisdexamfetamine
drug DRUGBANK Memantine
drug DRUGBANK Metamfetamine
drug DRUGBANK Modafinil
drug DRUGBANK Nalmefene
drug DRUGBANK Pemoline
drug DRUGBANK Reserpine
drug DRUGBANK Rivastigmine
drug DRUGBANK Imipramine
drug DRUGBANK Biperiden
drug DRUGBANK Diazepam
drug DRUGBANK Nitrazepam
drug DRUGBANK Esomeprazole
drug DRUGBANK Coenzyme M
disease MESH adverse drug reactions
disease MESH treatment resistant depression
disease MESH depressive disorders
drug DRUGBANK Benzodiazepine
drug DRUGBANK Clozapine
drug DRUGBANK Olanzapine
drug DRUGBANK Trestolone
disease MESH Syndrome
disease MESH Mood Disorders
disease MESH suicidal ideation
drug DRUGBANK Sulfasalazine
disease MESH treatment resistant schizophrenia
drug DRUGBANK Asenapine
drug DRUGBANK Aripiprazole

Original Article

(Visited 1 times, 1 visits today)

Leave a Comment

Your email address will not be published. Required fields are marked *