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. 2023 Jul-Aug;43(4):365-368.
doi: 10.1097/JCP.0000000000001704. Epub 2023 May 23.

Combination Psychotropic Use for Schizophrenia With Long-Acting Injectable Antipsychotics and Oral Antipsychotics: A Nationwide Real-World Study in Japan

Toshiaki Onitsuka  1 , Tsuyoshi Okada  2 , Naomi Hasegawa  3 , Takashi Tsuboi  4 , Jun-Ichi Iga  5 , Norio Yasui-Furukori  6 , Naoki Yamada  7 , Hikaru Hori  8 , Hiroyuki Muraoka  9 , Kazutaka Ohi  10 , Kazuyoshi Ogasawara  11 , Shinichiro Ochi  5 , Masahiro Takeshima  12 , Kayo Ichihashi  13 , Kentaro Fukumoto  14 , Hitoshi Iida  8 , Hisashi Yamada, Ryuji Furihata  15 , Manabu Makinodan  16 , Yoshikazu Takaesu  17 , Shusuke Numata  7 , Hiroshi Komatsu  18 , Akitoyo Hishimoto  19 , Mikio Kido, Kiyokazu Atake  20 , Hirotaka Yamagata  21 , Saya Kikuchi  18 , Naoki Hashimoto  22 , Masahide Usami  23 , Eiichi Katsumoto  24 , Takeshi Asami  19 , Chika Kubota, Junya Matsumoto  3 , Kenichiro Miura  3 , Yoji Hirano, Koichiro Watanabe  4 , Ken Inada  25 , Ryota Hashimoto  3
Affiliations

Combination Psychotropic Use for Schizophrenia With Long-Acting Injectable Antipsychotics and Oral Antipsychotics: A Nationwide Real-World Study in Japan

Toshiaki Onitsuka et al. J Clin Psychopharmacol. 2023 Jul-Aug.

Abstract

Background: Although several guidelines recommend monotherapy with antipsychotics for the treatment of schizophrenia, patients who receive long-acting injectable antipsychotics (LAIs) are frequently treated with oral antipsychotics (OAPs). In the present study, we investigated the detailed use of psychotropic medications among patients throughout Japan with schizophrenia who received LAIs or OAPs.

Methods: The present study used data from the project for the Effectiveness of Guidelines for Dissemination and Education in psychiatric treatment from 94 facilities in Japan. The LAI group included patients who received any LAI, and the non-LAI group included patients who took only OAP medications at discharge. The participants of this study were 2518 schizophrenia patients (263 in the LAI group and 2255 in the non-LAI group) who received inpatient treatment and had prescription information at discharge between 2016 and 2020.

Results: This study revealed significantly higher rates of polypharmacy antipsychotics, number of antipsychotics, and chlorpromazine equivalents in the LAI group than in the non-LAI group. In contrast, the LAI group showed lower rate of concomitant use of hypnotic and/or antianxiety medication than the non-LAI group.

Conclusions: Presenting these real-world clinical results, we want to encourage clinicians to keep monotherapy in mind for the treatment of schizophrenia, especially by reducing concomitant use of antipsychotics in the LAI group and reducing hypnotic and/or antianxiety medication in the non-LAI group.

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