Frontiers in Psychiatry (May 2022)
Prescription of Anticholinergic Drugs in Patients With Schizophrenia: Analysis of Antipsychotic Prescription Patterns and Hospital Characteristics
- Hikaru Hori,
- Norio Yasui-Furukori,
- Naomi Hasegawa,
- Jun-ichi Iga,
- Shinichiro Ochi,
- Kayo Ichihashi,
- Ryuji Furihata,
- Yoshitaka Kyo,
- Yoshikazu Takaesu,
- Takashi Tsuboi,
- Fumitoshi Kodaka,
- Toshiaki Onitsuka,
- Tsuyoshi Okada,
- Atsunobu Murata,
- Hiroko Kashiwagi,
- Hiroko Kashiwagi,
- Hitoshi Iida,
- Naoki Hashimoto,
- Kazutaka Ohi,
- Hisashi Yamada,
- Hisashi Yamada,
- Kazuyoshi Ogasawara,
- Yuka Yasuda,
- Yuka Yasuda,
- Hiroyuki Muraoka,
- Masahide Usami,
- Shusuke Numata,
- Masahiro Takeshima,
- Hirotaka Yamagata,
- Tatsuya Nagasawa,
- Hiromi Tagata,
- Manabu Makinodan,
- Mikio Kido,
- Mikio Kido,
- Eiichi Katsumoto,
- Hiroshi Komatsu,
- Junya Matsumoto,
- Chika Kubota,
- Kenichiro Miura,
- Akitoyo Hishimoto,
- Koichiro Watanabe,
- Ken Inada,
- Hiroaki Kawasaki,
- Ryota Hashimoto
Affiliations
- Hikaru Hori
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
- Naomi Hasegawa
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Jun-ichi Iga
- Department of Neuropsychiatry Molecules and Function, Ehime University Graduate School of Medicine, Matsuyama, Japan
- Shinichiro Ochi
- Department of Neuropsychiatry Molecules and Function, Ehime University Graduate School of Medicine, Matsuyama, Japan
- Kayo Ichihashi
- Department of Neuropsychiatry, University of Tokyo Hospital, Tokyo, Japan
- Ryuji Furihata
- Agency for Student Support and Disability Resources, Kyoto University, Kyoto, Japan
- Yoshitaka Kyo
- Department of Psychiatry, School of Medicine, Kitasato University, Tokyo, Japan
- Yoshikazu Takaesu
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
- Takashi Tsuboi
- Department of Neuropsychiatry, Kyorin University School of Medicine, Mitaka, Japan
- Fumitoshi Kodaka
- 0Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
- Toshiaki Onitsuka
- 1Department of Neuroimaging Psychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Tsuyoshi Okada
- 2Department of Psychiatry, Jichi Medical University, Tochigi, Japan
- Atsunobu Murata
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Hiroko Kashiwagi
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Hiroko Kashiwagi
- 3Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Kodaira, Japan
- Hitoshi Iida
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Naoki Hashimoto
- 4Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Kazutaka Ohi
- 5Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan
- Hisashi Yamada
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Hisashi Yamada
- 6Department of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, Japan
- Kazuyoshi Ogasawara
- 7Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, Nagoya, Japan
- Yuka Yasuda
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Yuka Yasuda
- 8Life Grow Brilliant Mental Clinic, Medical Corporation Foster, Osaka, Japan
- Hiroyuki Muraoka
- 9Department of Psychiatry, Tokyo Women’s Medical University, Tokyo, Japan
- Masahide Usami
- 0Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Japan
- Shusuke Numata
- 1Department of Psychiatry, Graduate School of Biomedical Science, Tokushima University, Tokushima, Japan
- Masahiro Takeshima
- 2Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
- Hirotaka Yamagata
- 3Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University School of Medicine, Yamaguchi, Japan
- Tatsuya Nagasawa
- 4Department of Neuropsychiatry, Kanazawa Medical University, Uchinada, Japan
- Hiromi Tagata
- 5Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo, Japan
- Manabu Makinodan
- 6Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
- Mikio Kido
- 7Toyama City Hospital, Toyama, Japan
- Mikio Kido
- 8Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Eiichi Katsumoto
- 9Katsumoto Mental Clinic, Oosaka, Japan
- Hiroshi Komatsu
- 0Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
- Junya Matsumoto
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Chika Kubota
- 3Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Kodaira, Japan
- Kenichiro Miura
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Akitoyo Hishimoto
- 1Department of Psychiatry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Koichiro Watanabe
- Department of Neuropsychiatry, Kyorin University School of Medicine, Mitaka, Japan
- Ken Inada
- 9Department of Psychiatry, Tokyo Women’s Medical University, Tokyo, Japan
- Hiroaki Kawasaki
- Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Ryota Hashimoto
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- DOI
- https://doi.org/10.3389/fpsyt.2022.823826
- Journal volume & issue
-
Vol. 13
Abstract
In several clinical guidelines for schizophrenia, long-term use of anticholinergic drugs is not recommended. We investigated the characteristics of the use of anticholinergics in patients with schizophrenia by considering psychotropic prescription patterns and differences among hospitals. A cross-sectional, retrospective prescription survey at the time of discharge was conducted on 2027 patients with schizophrenia from 69 Japanese hospitals. We examined the relations among psychotropic drug prescriptions regarding anticholinergic prescription. We divided the hospitals into three groups—low rate group (LG), medium rate group (MG), and high rate group (HG)—according to their anticholinergic prescription rates, and analyzed the relationship between anticholinergic prescription rates and antipsychotic prescription. Anticholinergic drugs were prescribed to 618 patients (30.5%), and the prescription rates were significantly higher for high antipsychotic doses, antipsychotic polypharmacy, and first-generation antipsychotics (FGAs) use. The anticholinergic prescription rate varied considerably among hospitals, ranging from 0 to 66.7%, and it was significantly higher in patients with antipsychotic monotherapy, antipsychotic polypharmacy, and normal and high doses of antipsychotics in HG than in those LG and MG. The anticholinergics prescription rate in patients with second-generation antipsychotic monotherapy in HG was also significantly higher than in those LG and MG; however, the difference was no longer significant in patients with FGA monotherapy. Conclusively, in addition to high antipsychotic doses, antipsychotic polypharmacy, and FGA use, hospital characteristics influence the prescribing of anticholinergic drugs.
Keywords
- schizophrenia
- anticholinergic drugs
- antipsychotic polypharmacy
- antipsychotic monotherapy
- first-generation antipsychotics
- second-generation antipsychotic (SGA)
