Abstract
BackgroundData on the pharmacological management of acute agitation in schizophrenia are scarce. The aim of this study is to investigate the prescription practices in the treatment of agitation in Chinese patients with schizophrenia.MethodsWe conducted a large, multicenter, observational study in 14 psychiatry hospitals in China. Newly hospitalized schizophrenia patients with the PANSS-EC total score ≥ 14 and a value ≥4 on at least one of its five items were included in the study. Their drug treatments of the first 2 weeks in hospital were recorded by the researchers.ResultsEight hundred and 53 patients enrolled in and 847 (99.30%) completed the study. All participants were prescribed antipsychotics, 40 (4.72%) were prescribed benzodiazepine in conjunction with antipsychotics and 81 were treated with modified electric convulsive therapy (MECT). Four hundred and 12 (48.64%) patients were prescribed only one antipsychotic, in the order of olanzapine (120 patients, 29.13%), followed by risperidone (101 patients, 24.51%) and clozapine (41 patients, 9.95%). About 435 (51.36%) participants received antipsychotic polypharmacy, mostly haloperidol + risperidone (23.45%), haloperidol+ olanzapine (17.01%), olanzapine+ ziprasidone (5.30%), haloperidol + clozapine (4.37%) and haloperidol + quetiapine (3.90%). Binary logistic regression analysis suggests that a high BARS score (OR 2.091, 95%CI 1.140–3.124), severe agitation (OR 1.846, 95%CL 1.266–2.693), unemployment or retirement (OR 1.614, 95%CL 1.189–2.190) and aggressiveness on baseline (OR 1.469, 95%CL 1.032–2.091) were related to an increased antipsychotic polypharmacy odds. Male sex (OR 0.592, 95%CL 0.436–0.803) and schizophrenia in older persons (age ≥ 55 years, OR 0.466, 95%CL 0.240–0.902) were less likely to be associated with antipsychotic polypharmacy.ConclusionThe present study demonstrates that monotherapy and polypharmacy display equally common patterns of antipsychotic usage in managing agitation associated with schizophrenia in China. The extent and behavioral activities of agitation and several other factors were associated with polypharmacy.
Highlights
Data on the pharmacological management of acute agitation in schizophrenia are scarce
According to the State of Acute Agitation at Psychiatric Emergencies in Europe (STAGE) study, schizophrenia was the underlying in 47.27% (78 of 165) of psychiatric agitation episodes [6]
Schizophrenia in China (IPTASC, Hongyan Zhang Group Investigators). This observational, multicenter, cross-sectional study is aimed to explore the patterns of antipsychotic use for agitation among newly hospitalized Chinese schizophrenia patients and to the factors possibly associated with the prescription pattern
Summary
Data on the pharmacological management of acute agitation in schizophrenia are scarce. The aim of this study is to investigate the prescription practices in the treatment of agitation in Chinese patients with schizophrenia. In the United States alone, agitated patients with schizophrenia accounted for 900,000 annual visits to psychiatric emergency services, representing 21% of all psychiatric emergency visits [5]. According to the State of Acute Agitation at Psychiatric Emergencies in Europe (STAGE) study, schizophrenia was the underlying in 47.27% (78 of 165) of psychiatric agitation episodes [6]. A considerable percentage of schizophrenia patients with agitation still require psychopharmacological approaches, including typical or first-generation antipsychotic drugs, atypical or second-generation antipsychotic drugs, and benzodiazepines [9, 10]. An array of pharmacological options administered via different routes exists, providing physicians with numerous treatment alternatives
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