Displaying publications 1 - 20 of 52 in total

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  1. Gender differences in depressive symptom profiles and patterns of psychotropic drug usage in Asian patients with depression: Findings from the Research on Asian Psychotropic Prescription Patterns for Antidepressants study
    Park SC, Lee MS, Shinfuku N, Sartorius N, Park YC
    Aust N Z J Psychiatry, 2015 Sep;49(9):833-41.
    PMID: 25829482 DOI: 10.1177/0004867415579464
    The purpose of this study was to investigate whether there were gender-specific depressive symptom profiles or gender-specific patterns of psychotropic agent usage in Asian patients with depression.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use
  2. Comparison of psychotropic prescriptions between oncology and cardiology inpatients: result from a pharmacy database in a teaching hospital in Malaysia
    Ng CG, Mohamed S, Wern TY, Haris A, Zainal NZ, Sulaiman AH
    Asian Pac J Cancer Prev, 2014;15(10):4261-4.
    PMID: 24935381
    OBJECTIVE: To examine the prescription rates in cancer patients of three common psychotropic drugs: anxiolytic/ hypnotic, antidepressant and antipsychotic.

    MATERIALS AND METHODS: In this retrospective cohort study, data were extracted from the pharmacy database of University Malaya Medical Center (UMMC) responsible for dispensing records of patients stored in the pharmacy's Medication Management and Use System (Ascribe). We analyzed the use of psychotropics in patients from the oncology ward and cardiology from 2008 to 2012. Odds ratios (ORs) were adjusted for age, gender and ethnicity.

    RESULTS: A total of 3,345 oncology patients and 8,980 cardiology patients were included. Oncology patients were significantly more often prescribed psychotropic drugs (adjusted OR: anxiolytic/hypnotic=5.55 (CI: 4.64-6.63); antidepressants=6.08 (CI: 4.83-7.64) and antipsychotics=5.41 (CI: 4.17-7.02). Non-Malay female cancer patients were at significantly higher risk of anxiolytic/hypnotic use.

    CONCLUSIONS: Psychotropic drugs prescription is common in cancer patients. Anxiolytic/hypnotic prescription rates are significantly higher in non-Malay female patients in Malaysia.

    Matched MeSH terms: Antipsychotic Agents/therapeutic use
  3. Cost analysis of risperidone long-acting injection in the treatment of schizophrenia and schizoaffective disorders in Hong Kong: an approach using generalised estimating equations
    Wu DB, Lee EH, Chung WS, Chow DP, Lee VW, Wong MC, et al.
    Psychiatry Res, 2013 Dec 30;210(3):745-50.
    PMID: 24012164 DOI: 10.1016/j.psychres.2013.07.012
    Schizophrenia is one of the most expensive psychiatric illnesses. This study compared retrospectively health-care resources consumed 12 months before and 24 months after risperidone long-acting injection (RLAI) treatment in Hong Kong. A mirror-image analysis was conducted using data (N=191) from three public hospitals in Hong Kong from 2003 to 2007. The main outcome measure was hospitalisation cost. Other secondary outcomes such as hospitalisation episodes, outpatient visits and adverse events were also compared. A predictive model was established using linear regression based on generalised estimating equations. Analysis showed that RLAI was associated with a reduction in hospitalisation cost by HK$10,001,390 (24.7%) (HK$40,418,694 vs. HK$30,417,303; P-value <0.05). Days of hospitalisation were reduced by 1538 days (10.1%) (15,271 vs. 13,733; P-value <0.05). The predictive model estimated that the hospitalisation cost of patients using RLAI was only 11.1% (3.1-3.93%, 95% confidence interval (CI)) compared to those receiving conventional antipsychotics combined with oral risperidone. Cost of hospitalisation was significantly reduced after RLAI therapy. However, results should be considered as indicative or suggestive only, due to potential channelling bias where certain drug regimens are preferentially prescribed to patients with particular conditions. The findings from our study may be useful in health-care decision making considering treatment options for schizophrenia in resource-limited settings.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use
  4. Fulltext Neuroleptic malignant syndrome masked by cerebral malaria
    Rajesh KM, Sinnathamby V, Sakthi AN
    BMJ Case Rep, 2013;2013.
    PMID: 23704432 DOI: 10.1136/bcr-2013-009061
    A 38-year-old man with an underlying psychiatric illness presented with altered sensorium and abnormal behaviour. He was febrile at 38°C and weak looking; otherwise no other abnormalities were detected. A blood film conducted for malarial parasite (BFMP) revealed Plasmodium falciparum; hence a diagnosis of cerebral malaria was made. He was treated with antimalarial drugs for 2 days prior to being transferred out to the ward following clinical improvement. He subsequently developed episodes of stupor and refusal of feeding. Following an evaluation by the psychiatrist, a diagnosis of catatonic schizophrenia was made and he was started on oral sulpiride and benhexol. Unfortunately, he developed high-grade fever at 40°C with muscle rigidity and fasciculation. The diagnosis of neuroleptic malignant syndrome (NMS) was clinched and the antipsychotics were discontinued. However he succumbed to NMS several days later due to multiorgan failure.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use
  5. Treatment with olanzapine, risperidone or typical antipsychotic drugs in Asian patients with schizophrenia
    Lee C, Wu KH, Habil H, Dyachkova Y, Lee P
    Aust N Z J Psychiatry, 2006 May;40(5):437-45.
    PMID: 16683970
    To examine clinical outcomes in Asian patients with schizophrenia receiving monotherapy with olanzapine, risperidone or typical antipsychotics in naturalistic settings.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use*
  6. Metabolic syndrome and antipsychotic monotherapy treatment among schizophrenia patients in Malaysia
    Said MA, Hatim A, Habil MH, Zafidah W, Haslina MY, Badiah Y, et al.
    Prev Med, 2013;57 Suppl:S50-3.
    PMID: 23337566 DOI: 10.1016/j.ypmed.2013.01.005
    OBJECTIVE: The objective of this study is to determine the prevalence of metabolic syndrome among schizophrenia patients receiving antipsychotic monotherapy in Malaysia.
    METHOD: A cross-sectional study was conducted at multiple centres between June 2008 and September 2011. Two hundred and five patients who fulfilled the DSM IV-TR diagnostic criteria for schizophrenia and who had been on antipsychotic medication for at least one year, were screened for metabolic syndrome. Patients receiving a mood stabilizer were excluded from the study. Metabolic syndrome was defined by using the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Treatment Panel III (ATP III) modified for Asian waist circumference.
    RESULTS: In the first-generation antipsychotic (FGA) group, the highest prevalence of metabolic syndrome was among patients treated with trifluoperazine and flupenthixol decanoate (66.7% each). For the second-generation antipsychotic (SGA) group, the highest prevalence of metabolic syndrome was among patients treated with clozapine (66.7%). The component with the highest prevalence in metabolic syndrome was waist circumference in both FGA and SGA groups except for aripiprazole in SGA.
    CONCLUSION: The prevalence of metabolic syndrome in schizophrenia patients receiving antipsychotic monotherapy in Malaysia was very high. Intervention measures are urgently needed to combat these problems.
    KEYWORDS: Antipsychotics; Metabolic syndrome; Monotherapy; Prevalence; Schizophrenia
    Matched MeSH terms: Antipsychotic Agents/therapeutic use*
  7. Real-world evidence of improved healthcare utilization in patients with schizophrenia or schizoaffective disorder after early treatment of paliperidone palmitate once-monthly treatment in Hong Kong
    Choon JWY, Wu DBC, Chong HY, Lo WTL, Chong CSY, Chung WS, et al.
    J Med Econ, 2019 Mar;22(3):273-279.
    PMID: 30561238 DOI: 10.1080/13696998.2018.1560749
    BACKGROUND: Very few data are available to demonstrate the economic benefit of early paliperidone palmitate once-monthly long-acting injectable (PP1M) treatment in patients with schizophrenia or schizoaffective disorder.

    METHODS AND MATERIALS: This study has retrospectively compared the healthcare utilization and associated costs of pre- and post-PPIM treatment in 413 patients with schizophrenia or schizoaffective disorder recruited from three major public hospitals providing psychiatric services in Hong Kong. Patients were categorized into early treatment (≤3 years since diagnosis) and chronic (>3 years) groups, and also whether they were receiving polypharmacy (POP).

    RESULTS: It was found that patients who were started on early therapy with no POP had the most favourable outcomes. Overall results of the entire cohort, including both early and late treatments, indicate that there was a slight increase in annual in-patient days (IP) per patient and outpatient visit (OP) by 3.18 and 1.87, respectively, and a decrease in emergency room visit (ER) of 0.9 (p 

    Matched MeSH terms: Antipsychotic Agents/therapeutic use*
  8. Association of FTO, LEPR and MTHFR gene polymorphisms with metabolic syndrome in schizophrenia patients receiving antipsychotics
    Roffeei SN, Mohamed Z, Reynolds GP, Said MA, Hatim A, Mohamed EH, et al.
    Pharmacogenomics, 2014 Mar;15(4):477-85.
    PMID: 24624915 DOI: 10.2217/pgs.13.220
    The occurrence of metabolic syndrome (MS) in schizophrenia patients receiving long-term antipsychotics (APs) contributes to their high mortality rate. We aimed to determine whether genetic polymorphisms of identified candidate genes are associated with MS in our study population.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use*
  9. Association of ADRA2A and MTHFR gene polymorphisms with weight loss following antipsychotic switching to aripiprazole or ziprasidone
    Roffeei SN, Reynolds GP, Zainal NZ, Said MA, Hatim A, Aida SA, et al.
    Hum Psychopharmacol, 2014 Jan;29(1):38-45.
    PMID: 24424705 DOI: 10.1002/hup.2366
    Various genetic polymorphisms have been reported to be associated with antipsychotic-induced weight gain. In this study, we aimed to determine whether risk polymorphisms in 12 candidate genes are associated with reduction in body mass index (BMI) of patients following switching of antipsychotics to aripiprazole or ziprasidone.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use
  10. Remitted male schizophrenia patients with sexual dysfunction
    Kheng Yee O, Muhd Ramli ER, Che Ismail H
    J Sex Med, 2014 Apr;11(4):956-965.
    PMID: 23845160 DOI: 10.1111/jsm.12246
    INTRODUCTION: Despite the high prevalence of sexual dysfunction among male schizophrenia patients, there is still a paucity of research on this area.
    AIMS: The study aims to determine the prevalence of sexual dysfunction and any association between male patients with schizophrenia in remission and the sociodemographic profile, medication, depression, anxiety, psychopathology of illness, body mass index, and waist circumference.
    METHODS: A cross-sectional study with nonprobability sampling method was conducted in a psychiatric outpatient clinic in Taiping Hospital (Perak, Malaysia) over a 7-month period. A total of 111 remitted male schizophrenia patients were recruited. The validated Malay version of the International Index of Erectile Function (Mal-IIEF-15) was administered to the patients and assessed over 4-week duration in the domains of erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. Logistic regression analysis was employed.
    MAIN OUTCOME MEASURES: Prevalence and associated factors for sexual dysfunction in each domain are the main outcome measures.
    RESULTS: All five domains of sexual functioning in patients showed a high prevalence of dysfunction ranging from 78.4% to 97.1% with orgasmic dysfunction being the least impaired and intercourse satisfaction the worst impaired. Among the domains, only orgasmic dysfunction was significantly associated with race, i.e., Chinese at lower risk for impairment than the Malays (OR = 0.23; 95% CI: 0.07, 0.76; P = 0.018); education, i.e., patients with education higher than primary level were at higher risk for dysfunction (OR = 6.49; 95% CI: 1.32, 32.05; P = 0.022); and Positive and Negative Syndrome Scale (PANSS)-positive subscale, i.e., higher PANSS-positive score was a protective factor for orgasmic dysfunction (OR = 0.54; 95% CI: 0.33, 0.89; P = 0.015).
    CONCLUSIONS: The prevalence of sexual dysfunction was generally high. Malay patients and those with education higher than primary level were at higher risk for orgasmic dysfunction whereas higher PANSS-positive score was protective against the impairment. The high rate of sexual dysfunction in schizophrenia patients warrants a routine inquiry into patients' sexuality and the appropriate problems being addressed.
    Study site: Psychiatric clinic, Hospital Taiping, Perak, Malaysia
    Matched MeSH terms: Antipsychotic Agents/therapeutic use
  11. Prescribing patterns of low doses of antipsychotic medications in older Asian patients with schizophrenia, 2001-2009
    Xiang YT, Dickerson F, Kreyenbuhl J, Ungvari GS, Wang CY, Si TM, et al.
    Int Psychogeriatr, 2012 Jun;24(6):1002-8.
    PMID: 22300452 DOI: 10.1017/S1041610211002791
    This study examined the use of low doses of antipsychotic medications (300 mg/day CPZeq or less) in older Asian patients with schizophrenia and its demographic and clinical correlates.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use*
  12. A randomized, placebo-controlled trial of aripiprazole for the treatment of methamphetamine dependence and associated psychosis
    Sulaiman AH, Gill JS, Said MA, Zainal NZ, Hussein HM, Guan NC
    Int J Psychiatry Clin Pract, 2013 Jun;17(2):131-8.
    PMID: 22486597 DOI: 10.3109/13651501.2012.667116
    The objectives of this study were to determine the efficacy and safety of aripiprazole for treatment of psychosis, retention and abstinence in patients with methamphetamine dependence.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use*
  13. Fulltext Branch retinal vein occlusion associated with quetiapine fumarate
    Yong KC, Kah TA, Ghee YT, Siang LC, Bastion ML
    BMC Ophthalmol, 2011;11:24.
    PMID: 21867521 DOI: 10.1186/1471-2415-11-24
    To report a case of branch retinal vein occlusion in a young adult with bipolar mood disorder treated with quetiapine fumarate.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use
  14. A prospective study on the pattern of medication use for schizophrenia in the outpatient pharmacy department, Hospital Tengku Ampuan Rahimah, Selangor, Malaysia
    Ponto T, Ismail NI, Abdul Majeed AB, Marmaya NH, Zakaria ZA
    Methods Find Exp Clin Pharmacol, 2010 Jul-Aug;32(6):427-32.
    PMID: 20852752 DOI: 10.1358/mf.2010.32.6.1477907
    Schizophrenia is a chronic psychiatric disorder and pharmacotherapy plays a major role in its management. The 1950s and early 1960s saw milestones in the introduction of psychotropic drugs in clinical practice. A review of drug prescriptions in different settings provides an insight into the pattern of drug use, identifies drug-related problems and may be used to compare recommended guidelines with actual practice. This effort led to the evaluation of the drug prescribing pattern of antipsychotics in patients attending the psychiatric clinic at a government hospital. The data from 371 antipsychotic medication prescriptions that included 200 prescriptions for schizophrenia were collected during one month (1rst-31rst August 2008) at the outpatient pharmacy department. The mean age of patients was 35.0 years (SD = 1.131), with a male to female ratio of 2:1. The most widely used oral antipsychotic was haloperidol (16.3%) while the most common depot preparation prescribed was zuclopenthixol decanoate (8.8%). The daily dose of the average antipsychotic prescribed in this clinic was 342.06 mg equivalent of chlorpromazine. There was no relation between the doses received and ethnicity of the patient (Malay, Chinese or Indian). However, there was a significant relationship between the prescribed dose and patient age (P < 0.042). Nearly 32% of the schizophrenia patients were prescribed with atypical antipsychotics such as olanzapine (10.8%), risperidone (10.0%), quetiapine (7.6%) and clozapine (3.2%). Monotherapy was given to 73.0% of the schizophrenia patients. The majority of patients also received antidepressants. To conclude, this study gave evidence that physicians had a strong preference for monotherapy with conventional antipsychotic drugs while the use of atypical drugs was less prevalent.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use*
  15. Outcome study of first-episode schizophrenia in a developing country: quality of life and antipsychotics
    Chee KY
    Soc Psychiatry Psychiatr Epidemiol, 2009 Feb;44(2):143-50.
    PMID: 18642120 DOI: 10.1007/s00127-008-0415-0
    AIM: Quality of life has recently been emphasized in the management of schizophrenia, yet data from developing country is lacking. We explored the differences in subjective quality of life between conventional antipsychotics (CAs) and atypical antipsychotics (AAs).

    METHODS: This is a naturalistic study conducted in Kuala Lumpur, Malaysia. Patients with first-episode schizophrenia and related psychosis were recruited from Kuala Lumpur Hospital. WHOQOL-BREF, side effects of medications and other variables were assessed after 1 year of treatment in routine clinical situation.

    RESULTS: The study comprised 120 adults. There were no significant statistical differences between groups concerning subjective quality of life, extrapyramidal side effects and employment. Significant less benzhexol usage was reported among AAs (P<0.001) compared to CAs and sulpiride.

    CONCLUSION: Patients treated with CAs, sulpiride or AAs experienced similar quality of life, clinical and health outcomes after 1 year commencing treatment. Overall, the results are in line with other major pragmatic clinical trials. This study also found sulpiride cost-effective.

    Matched MeSH terms: Antipsychotic Agents/therapeutic use*
  16. Use of electroconvulsive therapy for Asian patients with schizophrenia (2001-2009): Trends and correlates
    Xiang YT, Ungvari GS, Correll CU, Chiu HF, Lai KY, Wang CY, et al.
    Psychiatry Clin Neurosci, 2015 Aug;69(8):489-96.
    PMID: 25708964 DOI: 10.1111/pcn.12283
    Little is known about electroconvulsive therapy (ECT) use in Asian inpatients with schizophrenia. This study examined trends of ECT use for schizophrenia patients in Asia between 2001 and 2009 and its independent demographic and clinical correlates.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use
  17. Paradoxical pinpoint pupils with asenapine
    Gill JS, Jambunathan S, Wong S, Wong A
    Asia Pac Psychiatry, 2015 Jun;7(2):230.
    PMID: 25923587 DOI: 10.1111/appy.12171
    Matched MeSH terms: Antipsychotic Agents/therapeutic use
  18. Clinical evaluation and serum concentration of zuclopenthixol acetate in psychotic Asian patients: a single-dose preliminary study
    Tan CH, Low BL, Ng LL, Khoo YM, Lee HS
    Ther Drug Monit, 1993 Apr;15(2):108-12.
    PMID: 8099240
    Nineteen acutely disturbed psychotic Asian patients were treated with a single intramuscular injection of 50 mg of zuclopenthixol acetate in Viscoleo. Patients were assessed clinically before and after treatment using the Brief Psychiatric Rating Scale (BPRS). Serum zuclopenthixol and the inactive geometric isomer trans(E)-clopenthixol were determined by high-performance liquid chromatography after intramuscular injection. All patients improved, with the BPRS being significantly reduced (p < 0.001) at 72 h after injection. Adverse effects were generally few. The mean +/- SEM serum zuclopenthixol concentrations at 24, 48, and 72 h were 19.9 +/- 2.8, 31.5 +/- 4.5, and 17.8 +/- 2.9 micrograms/L, respectively. trans(E)-Clopenthixol concentrations ranged from negligible to 39.5 micrograms/L. This study confirms that a single intramuscular injection of 50 mg is adequate for managing severely disturbed psychotic patients for the first 3 days. The serum zuclopenthixol concentrations attained in the Asian patients were higher than those reported in Caucasian psychiatric patients. In some patients, a considerable amount of zuclopenthixol had been transformed to trans(E)-clopenthixol.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use
  19. Hypersexuality As a Neuropsychiatric Disorder: The Neurobiology and Treatment Options
    Asiff M, Sidi H, Masiran R, Kumar J, Das S, Hatta NH, et al.
    Curr Drug Targets, 2018;19(12):1391-1401.
    PMID: 28325146 DOI: 10.2174/1389450118666170321144931
    Hypersexuality refers to abnormally increased or extreme involvement in any sexual activity. It is clinically challenging, presents trans-diagnostically and there is extensive medical literature addressing the nosology, pathogenesis and neuropsychiatric aspects in this clinical syndrome. Classification includes deviant behaviours, diagnosable entities related to impulsivity, and obsessional phenomena. Some clinicians view an increase in sexual desire as 'normal' i.e. psychodynamic theorists consider it as egodefensive at times alleviating unconscious anxiety rooted in intrapsychic conflicts. We highlight hypersexuality as multi-dimensional involving an increase in sexual activity that is associated with distress and functional impairment. The aetiology of hypersexuality is multi-factorial with differential diagnoses that include major psychiatric disorders (e.g. bipolar disorder), adverse effects of treatments (e.g. levodopatreatment), substance-induced disorders (e.g. amphetamine substance use), neuropathological disorders (e.g. frontal lobe syndrome), among others. Numerous neurotransmitters are implicated in its pathogenesis, with dopamine and noradrenaline playing a crucial role in the neural reward pathways and emotionally- regulated limbic system neural circuits. The management of hypersexuality is determined by the principle of de causa effectu evanescent, if the causes are treated, the effect may disappear. We aim to review the role of pharmacological agents causing hypersexuality and centrally acting agents treating the associated underlying medical conditions. Bio-psycho-social determinants are pivotal in embracing the understanding and guiding management of this complex and multi-determined clinical syndrome.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use
  20. Fulltext Metabolic syndrome and cardiovascular risk among patients with schizophrenia receiving antipsychotics in Malaysia
    Said MA, Sulaiman AH, Habil MH, Das S, Bakar AK, Yusoff RM, et al.
    Singapore Med J, 2012 Dec;53(12):801-7.
    PMID: 23268153
    INTRODUCTION:This study aimed to determine the prevalence of metabolic syndrome and risk of coronary heart disease (CHD) in patients with schizophrenia receiving antipsychotics in Malaysia.
    METHODS:This cross-sectional study, conducted at multiple centres, involved 270 patients who fulfilled the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR diagnostic criteria for schizophrenia, were on antipsychotic medications for at least one year, and were screened for metabolic syndrome. Patients receiving mood stabilisers were excluded. Metabolic syndrome was defined according to the National Cholesterol Education Program ATP III criteria modified for Asian waist circumference. Risk for cardiovascular disease was assessed by using Framingham function (all ten-year CHD events).
    RESULTS:The prevalence of metabolic syndrome was 46.7% (126/270). Among all the antipsychotics used, atypical antipsychotics (monotherapy) were most commonly used in both the metabolic and non-metabolic syndrome groups (50.8% vs. 58.3%). The ten-year risk for CHD was significantly higher in patients with metabolic syndrome. The proportion of patients with high/very high risk for CHD (Framingham ≥ 10%) was greater in patients with metabolic syndrome than in those with non-metabolic syndrome (31.5% vs. 11.0%, odds ratio 3.9, 95% confidence interval 2.0-7.6; p < 0.001). The mean body mass index was higher in patients with metabolic syndrome than in those without (29.4 ± 5.1 kg/m2 vs. 25.0 ± 5.6 kg/m2; p < 0.001).
    CONCLUSION:Patients with schizophrenia receiving antipsychotics in Malaysia have a very high incidence of metabolic syndrome and increased cardiovascular risk. Urgent interventions are needed to combat these problems in patients.
    Matched MeSH terms: Antipsychotic Agents/therapeutic use*
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