Clozapine Treatment Is Associated With Higher Prescription Rate of Antipsychotic Monotherapy and Lower Prescription Rate of Other Concomitant Psychotropics : A Real-World Nationwide Study

Ochi, Shinichiro; Tagata, Hiromi; Hasegawa, Naomi; Yasui-Furukori, Norio; Iga, Jun-ichi; Kashiwagi, Hiroko; Kodaka, Fumitoshi; Komatsu, Hiroshi; Tsuboi, Takashi; Tokutani, Akira; Numata, Shusuke; Ichihashi, Kayo; Onitsuka, Toshiaki; Muraoka, Hiroyuki; Iida, Hitoshi; Ohi, Kazutaka; Atake, Kiyokazu; Kishimoto, Taishiro; Hori, Hikaru; Takaesu, Yoshikazu; Takeshima, Masahiro; Usami, Masahide; Makinodan, Manabu; Hashimoto, Naoki; Fujimoto, Michiko; Furihata, Ryuji; Nagasawa, Tatsuya; Yamada, Hisashi; Matsumoto, Junya; Miura, Kenichiro; Kido, Mikio; Hishimoto, Akitoyo; Ueno, Shu-ichi; Watanabe, Koichiro; Inada, Ken; Hashimoto, Ryota

doi:10.1093/ijnp/pyac036

Total for the last 12 months

number of access : ? 件

number of downloads : ?

Use this link to cite this item : https://repo.lib.tokushima-u.ac.jp/118579

ID	118579
Title Alternative	Clozapine and Antipsychotic Monotherapy
Author	Ochi, Shinichiro Ehime University Tagata, Hiromi Toho University Hasegawa, Naomi National Center of Neurology and Psychiatry Yasui-Furukori, Norio Dokkyo Medical University Iga, Jun-ichi Ehime University KAKEN Search Researchers Kashiwagi, Hiroko National Center of Neurology and Psychiatry Kodaka, Fumitoshi The Jikei University School of Medicine Komatsu, Hiroshi Tohoku University Tsuboi, Takashi Kyorin University Tokutani, Akira Hyogo College of Medicine Numata, Shusuke Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers Ichihashi, Kayo University of Tokyo Onitsuka, Toshiaki Kyushu University Muraoka, Hiroyuki Tokyo Women’s Medical University Iida, Hitoshi Fukuoka University Ohi, Kazutaka Gifu University Atake, Kiyokazu Nippon Telegraph and Telephone West Corporation Kishimoto, Taishiro Keio University Hori, Hikaru Fukuoka University Takaesu, Yoshikazu University of the Ryukyus Takeshima, Masahiro Akita University Usami, Masahide Kohnodai Hospital Makinodan, Manabu Nara Medical University Hashimoto, Naoki Hokkaido University Fujimoto, Michiko National Center of Neurology and Psychiatry\|Osaka University Furihata, Ryuji Kyoto University Nagasawa, Tatsuya Kanazawa Medical University Yamada, Hisashi National Center of Neurology and Psychiatry\|Hyogo College of Medicine Matsumoto, Junya National Center of Neurology and Psychiatry Miura, Kenichiro National Center of Neurology and Psychiatry Kido, Mikio Toyama City Hospital\|University of Toyama Hishimoto, Akitoyo Yokohama City University Ueno, Shu-ichi Ehime University Watanabe, Koichiro Kyorin University Inada, Ken Kitasato University Hashimoto, Ryota National Center of Neurology and Psychiatry
Keywords	Treatment-resistant schizophrenia lithium polypharmacy guideline EGUIDE
Content Type	Journal Article
Description	Background: Although clozapine is effective for treatment-resistant schizophrenia (TRS), the rate of clozapine prescription is still low. Whereas antipsychotic monotherapy is recommended in clinical practice guidelines, the rate of antipsychotic polypharmacy is still high. There is little evidence on whether a clozapine prescription influences changes in the rate of monotherapy and polypharmacy, including antipsychotics and other psychotropics. We therefore hypothesized that the rate of antipsychotic monotherapy in patients with TRS who were prescribed clozapine would be higher than that in patients with schizophrenia who were not prescribed clozapine. Methods: We assessed 8306 patients with schizophrenia nationwide from 178 institutions in Japan from 2016 to 2019. We analyzed the psychotropic prescription data at discharge in patients diagnosed with TRS and with no description of TRS (ND-TRS) based on the diagnosis listed in the discharge summary. Results: The rate of antipsychotic monotherapy in the TRS with clozapine group (91.3%) was significantly higher than that in the TRS without clozapine group (45.9%; P < 2.0 × 10−16) and the ND-TRS without clozapine group (54.7%; P < 2.0 × 10−16). The rate of antipsychotic monotherapy without any other concomitant psychotropics in the TRS with clozapine group (26.5%) was significantly higher than that in the TRS without clozapine group (12.6%; P = 1.1 × 10−6) and the ND-TRS without clozapine group (17.0%; P = 5.9 × 10−6). Conclusions: Clozapine prescription could be associated with a high rate of antipsychotic monotherapy. Patients will benefit from the correct diagnosis of TRS and thus from proper clozapine prescription.
Journal Title	International Journal of Neuropsychopharmacology
ISSN	14611457 14695111
NCID	AA11545519
Publisher	Oxford University Press
Volume	25
Issue	10
Start Page	818
End Page	826
Published Date	2022-06-20
Rights	This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
EDB ID	396294
DOI (Published Version)	10.1093/ijnp/pyac036
URL ( Publisher's Version )	https://doi.org/10.1093/ijnp/pyac036
FullText File	ijnp_25_10_818.pdf 287 KB
language	eng
TextVersion	Publisher
departments	Medical Sciences