Concurrent antipsychotic use in older adults treated with antidepressants in Asia

Dong M 1 , Zeng LN 2 , Zhang Q 3 , Ungvari GS 4 , Ng CH 5 , Chiu HFK 6 Show all authors , Si TM 7 , Sim K 8 , Avasthi A 9 , Grover S 9 , Chong MY 10 , Chee KY 11 , Kanba S 12 , Lee MS 13 , Yang SY 14 , Udomratn P 15 , Kallivayalil RA 16 , Tanra AJ 17 , Maramis MM 18 , Shen WW 19 , Sartorius N 20 , Mahendran R 21 , Tan CH 22 , Shinfuku N 23 , Xiang YT 1

Affiliations 

  • 1 Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
  • 2 Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
  • 3 The National Clinical Research Center for Mental Disorders, China & Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
  • 4 University of Notre Dame Australia, Fremantle, Australia
  • 5 Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
  • 6 Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
  • 7 Peking University Institute of Mental Health (the sixth Hospital) & National Clinical Research Center for Mental Disorders & the key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
  • 8 Institute of Mental Health, Singapore, Singapore
  • 9 Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
  • 10 Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi & Chang Gung University, Taoyuan, Taiwan
  • 11 Department of Psychiatry & Mental Health, Tunku Abdul Rahman Institute of Neurosciences, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
  • 12 Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
  • 13 Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea
  • 14 Department of Pharmacy, Songde Branch, Taipei City Hospital, & College of Medicine, Fu Jen Catholic University, Taipei, Taiwan
  • 15 Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
  • 16 Department of Psychiatry, Pushpagiri Institute of Medical Sciences, Thiruvalla, India
  • 17 Department of Psychiatry, Hasanuddin University Faculty of Medicine, Makassar, Indonesia
  • 18 Dr. Soetomo Hospital - Faculty of Medicine, Airlangga University, Surabaya, Jawa Timur, Indonesia
  • 19 Departments of Psychiatry, TMU-Wan Fang Medical Center and School of Medicine, Taipei Medical University, Taipei, Taiwan
  • 20 Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
  • 21 Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
  • 22 Department of Pharmacology, National University of Singapore, Singapore, Singapore
  • 23 International Center for Medical Research, Kobe University School of Medicine, Kobe, Japan
Psychogeriatrics, 2019 Jul;19(4):333-339.
PMID: 30734411 DOI: 10.1111/psyg.12416

Abstract

AIM: Depressive disorders are common in old age. Antipsychotics (APs) are often used as an adjunctive treatment with antidepressants (ADs) in this population but its patterns of use in Asia are not known. This study explored the rate of combination of APs and ADs in older adult psychiatric patients in Asia.

METHODS: This is a secondary analysis of the database of a multicentre study which recorded participants' basic demographical and clinical data in standardised format in 10 Asian countries and territories. The data were analysed using univariate and multivariate logistic regression analyses.

RESULTS: A total of 955 older adult psychiatric in- and outpatients were included in this study. The proportion of concurrent AP and AD use was 32.0%, ranging from 23.3% in Korea to 44.0% in Taiwan. Multivariate logistic regression analysis found that younger age, inpatient status and diagnosis of schizophrenia, anxiety and other mental disorders were significantly related to a higher proportion of concurrent use of APs and ADs.

CONCLUSION: Around a third of older adult psychiatric patients had concurrent AP and AD use in the Asian countries/regions surveyed. Considering the uncertain effectiveness and questionable safety of the AP and AD combination in this patient population, such should be cautiously used.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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