Objectives: The relationship between age and prescribed antipsychotic dose in patients with schizophrenia has been examined by assuming only a linear correlation in two age subgroups at most. The age of illness onset has also not been under adequate consideration in past prescription surveys. The objective of this study was to better evaluate these age effects on antipsychotic dose prescribed in these patients across a broad age range.
Methods: Review of prescriptions for antipsychotic medications in patients with schizophrenia spectrum disorders was conducted across 30 sites in Tokyo. A total of 1,418 patients (655 inpatients, 763 males, age range: 16.6-90.2 years) were studied.
Results: Age had significant effects on prescribed antipsychotic dose; the dose increased with age through the third decade, subsequently plateaued, and decreased after the fifth decade. The age of illness onset also had significant effects on the dose; late-onset schizophrenia (LOS) and very-late-onset schizophrenia-like psychoses (VLOS) patients received lower doses than early onset schizophrenia (EOS) patients. LOS and VLOS patients who did not experience any hospitalization for the previous year were treated with (1/2) and (1/3), respectively, of the dose for EOS of comparable current age.
Conclusion: Our results suggested biphasic effects of age on antipsychotic dose prescribed in patients with schizophrenia spectrum disorders. The natural history of schizophrenia and physiological aging may contribute to this inverted U-shaped relationship. In addition, our results may add another evidence of distinction among EOS, LOS, and VLOS from a clinical psychopharmacological perspective.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/JGP.0b013e318172b42d | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Efficacy and Safety of Sulforaphane Added to Antipsychotics for the Treatment of Negative Symptoms of Schizophrenia: A Randomized Controlled Trial.
J Clin Psychiatry
January 2025
Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, and Department of Psychiatry, New York University School of Medicine, New York, New York.
There are few established treatments for negative symptoms in schizophrenia, which persist in many patients after positive symptoms are reduced. Oxidative stress, inflammation, and epigenetic modifications involving histone deacetylase (HDAC) have been implicated in the pathophysiology of schizophrenia. Sulforaphane has antioxidant properties and is an HDAC inhibitor.
View Article and Find Full Text PDFBaseline Cardiovascular Risk Factors in Patients With Severe Mental Illness (SMI) and Second Generation Antipsychotic Use From the Fixed Dose Intervention Trial of New England Enhancing Survival in SMI (FITNESS).
J Clin Psychiatry
January 2025
Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts.
Individuals with severe mental illness (SMI) have a shorter life expectancy compared to the general population, largely due to cardiovascular disease (CVD). In this report from the Fixed Dose Intervention Trial of New England Enhancing Survival in SMI Patients (FITNESS), we examined baseline CVD risk factors and their treatment in patients with SMI and second generation antipsychotic (SGA) use. FITNESS enrolled 204 participants with SMI and SGA use, but without documented history of CVD or diabetes mellitus, from several clinics in the Boston, Massachusetts, area between April 29, 2015, and September 26, 2019.
View Article and Find Full Text PDFAn Educational Intervention to Promote Central Nervous System-Active Deprescribing in Dementia: A Pilot Study.
Drugs Aging
January 2025
Center for Clinical Management Research, VA Ann Arbor Healthcare System, NCRC 016-308E, 2800 Plymouth Rd, Ann Arbor, MI, 48109, USA.
Background: Central nervous system (CNS)-active polypharmacy (defined as concurrent exposure to three or more antidepressant, antipsychotic, antiseizure, benzodiazepine, opioid, or nonbenzodiazepine benzodiazepine receptor agonists) is associated with significant potential harms in persons living with dementia (PLWD).We conducted a pilot trial to assess a patient nudge intervention's implementation feasibility and preliminary effectiveness to prompt deprescribing conversations between PLWD experiencing CNS-active polypharmacy and their primary care clinicians ("clinicians").
Methods: We used the electronic health record to identify PLWD prescribed CNS-active polypharmacy in primary care clinics from two health systems.
Metoclopramide-induced rapid-onset psychosis in a child with methylphenidate use: a case report.
Turk J Pediatr
December 2024
Department of Pediatric Neurology, Ankara Bilkent City Hospital, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara, Türkiye.
Background: Metoclopramide, a dopamine antagonist employed for its antiemetic effects, can precipitate neuropsychiatric adverse effects, including extrapyramidal symptoms and, in a few instances, acute psychosis. Although there have been reports of metoclopramide-induced psychosis in elderly individuals, there is no documentation of such incidents in children as far as we are aware.
Case Presentation: This case report describes an 11-year-old girl with a history of mild intellectual disability and attention deficit hyperactivity disorder, managed with 10 mg of methylphenidate daily.
An Evaluation of Iloperidone for Mania in Bipolar I Disorder.
Ann Pharmacother
January 2025
Division of Pharmacy Practice and Administration, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA.
Objective: To review the efficacy of iloperidone for mania associated with bipolar I disorder and discuss its safety profile (eg, QTc prolongation, orthostatic hypotension, and metabolic adverse effects).
Data Sources: Literature was identified using PubMed (1966-September 2024), OVID (1984-November 2024), and clinicaltrials.gov.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!