Abstract
BackgroundThere is limited evidence on the use of antipsychotics in patients with early-onset schizophrenia, which lags significantly behind the studies on adult patients’ medication and has a large disparity from actual clinical needs. Hence, this study aims to analyse the status of the drug use and its changes for patients with early-onset schizophrenia in our ward and to provide references on clinical medications for children and adolescents with schizophrenia.MethodsThe distribution of antipsychotics on the day of discharge and their changes over time were retrospectively analysed in our inpatient department from March 2012 to July 2019. Descriptive statistical methods and χ2 tests were carried out.ResultsA total of 746 inpatients with early-onset schizophrenia were included. Among them, 99.3% of patients were prescribed atypical antipsychotic drugs, with 5.5% of patients prescribed typical antipsychotic drugs. The top five most commonly used antipsychotics were aripiprazole, olanzapine, risperidone, paliperidone and clozapine. Olanzapine and risperidone were used more frequently in men (P < 0.01), whereas aripiprazole was used less frequently (P < 0.01). Olanzapine and paliperidone were used more frequently in patients with adolescent-onset schizophrenia (AOS) (P < 0.05), and risperidone was used more frequently in patients with child-onset schizophrenia (COS) (P < 0.01). Multiple antipsychotics during hospitalization were prescribed in 23.1% of patients. The combination of aripiprazole and olanzapine was the most common in the AOS group, and the combination of risperidone and clozapine was the most common in the COS group. Before and after approval by the competent Chinese authorities, the use of paliperidone and aripiprazole tended to be stable.ConclusionAtypical antipsychotics have been increasingly valued and used clinically. The consideration of medications for patients with early-onset schizophrenia needs to include factors such as age, sex, and severity of illness, metabolism and cognitive function at baseline.
Highlights
There is limited evidence on the use of antipsychotics in patients with early-onset schizophrenia, which lags significantly behind the studies on adult patients’ medication and has a large disparity from actual clinical needs
Atypical antipsychotics have proven to be safer and more effective, so they gradually have become the first-line drugs in the treatment of schizophrenia in children and adolescents [4, 5]
The combination of aripiprazole and olanzapine was that most commonly seen in the adolescent-onset schizophrenia (AOS) group, and the combination of risperidone and clozapine was that most commonly used in the child-onset schizophrenia (COS) group (Table 3)
Summary
There is limited evidence on the use of antipsychotics in patients with early-onset schizophrenia, which lags significantly behind the studies on adult patients’ medication and has a large disparity from actual clinical needs. This study aims to analyse the status of the drug use and its changes for patients with earlyonset schizophrenia in our ward and to provide references on clinical medications for children and adolescents with schizophrenia. A meta-analysis [6] that included randomized controlled studies between 1967 and 2017 showed that aripiprazole, olanzapine, risperidone, paliperidone and quetiapine have a significantly better therapeutic effect on patients with early-onset schizophrenia than placebo and that paliperidone, risperidone, olanzapine and quetiapine are somewhat better accepted than placebo. Few antipsychotics at present have been approved to be used in children and adolescents, which has led to off-label use in treatment [9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
