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Kikuchi D, Obara T, Obara R, Hino H, Suzuki N, Kashiwagura S, Watanabe T, Ouchi R, Usui K, Okada K. Temporal trends in antipsychotic prescriptions for pediatric patients using an administrative hospital database in Japan: a retrospective study. J Pharm Health Care Sci 2024; 10:2. [PMID: 38169445 PMCID: PMC10763017 DOI: 10.1186/s40780-023-00324-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Schizophrenia is a psychiatric disorder characterized by hallucinations, delusions, and other symptoms. Although treatment guidelines for schizophrenia have been established in Japan, drugs are not recommended for pediatric schizophrenia. Additionally, the temporal trends in prescribing antipsychotics for pediatric patients with schizophrenia are unclear. Therefore, we aimed to clarify the trends in antipsychotic prescriptions for Japanese pediatric outpatients from 2015 to 2022. METHODS Administrative data (as of November 2023) of Japanese pediatric outpatients with schizophrenia aged 0-18 years who visited acute-care diagnosis procedure combination hospitals between January 1, 2015, and December 31, 2022, were included in this study. The target drugs for schizophrenia were all indicated for treating schizophrenia and marketed in Japan as of December 2022. Annual prescription trends for antipsychotics during this period were calculated based on their proportions. The Cochran-Armitage trend test was used to evaluate the proportion of prescriptions for each antipsychotic. RESULTS The main drugs prescribed for these patients were aripiprazole and risperidone. Among male patients, the proportion of prescriptions for aripiprazole increased significantly from 21.2% in 2015 to 35.9% in 2022, whereas that for risperidone decreased significantly from 47.9% in 2015 to 36.7% in 2022 (both P < 0.001). Among female patients, the proportion of prescriptions for aripiprazole increased significantly from 21.6% in 2015 to 35.6% in 2022, whereas that for risperidone decreased significantly from 38.6% in 2015 to 24.8% in 2022 (both P < 0.001). CONCLUSIONS Aripiprazole and risperidone were primarily prescribed for pediatric schizophrenia in Japan during the study period. Additionally, the proportion of aripiprazole prescriptions increased over time.
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Affiliation(s)
- Daisuke Kikuchi
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Miyagi, Japan
| | - Taku Obara
- Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, 980-8573, Miyagi, Japan
- Division of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, 2-1, Seiryo-machi, Aoba-ku, Sendai, 980-8573, Miyagi, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba- ku, Sendai, 980-8574, Miyagi, Japan
| | - Ryo Obara
- Department of Pharmacy, Kawasaki Kokoro Hospital, 72, Kitakawarayama, Oaza-Kawauchi, Kawasaki-cho, Shibata-gun, Miyagi, 980-8574, Japan
| | - Hiroaki Hino
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Miyagi, Japan
| | - Naoto Suzuki
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Miyagi, Japan
| | - Shota Kashiwagura
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Miyagi, Japan
| | - Takashi Watanabe
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Miyagi, Japan
- Division of Clinical Pharmaceutics and Pharmacy Practice, Tohoku Medical and Pharmaceutical University, 1-12-1, Fukumuro, Miyagino-ku, Sendai, 980-8512, Miyagi, Japan
| | - Ryusuke Ouchi
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Miyagi, Japan
- Division of Clinical Pharmaceutics and Pharmacy Practice, Tohoku Medical and Pharmaceutical University, 1-12-1, Fukumuro, Miyagino-ku, Sendai, 980-8512, Miyagi, Japan
| | - Kensuke Usui
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Miyagi, Japan
- Division of Clinical Pharmaceutics and Pharmacy Practice, Tohoku Medical and Pharmaceutical University, 1-12-1, Fukumuro, Miyagino-ku, Sendai, 980-8512, Miyagi, Japan
| | - Kouji Okada
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, 983-8512, Miyagi, Japan.
- Division of Clinical Pharmaceutics and Pharmacy Practice, Tohoku Medical and Pharmaceutical University, 1-12-1, Fukumuro, Miyagino-ku, Sendai, 980-8512, Miyagi, Japan.
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Deng SW, Xu Q, Jiang WL, Hong B, Li BH, Sun DW, Yang HB. Efficacy and safety of blonanserin versus risperidone in the treatment of schizophrenia: a systematic review and meta-analysis of randomized controlled trials. BMC Psychiatry 2023; 23:740. [PMID: 37821875 PMCID: PMC10568781 DOI: 10.1186/s12888-023-05240-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/30/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of blonanserin and risperidone for the treatment of schizophrenia and to provide reliable pharmacotherapeutic evidence for in the clinical treatment of schizophrenia. METHODS We systematically searched the PubMed, Cochrane Library, Embase, Chinese Biomedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) databases for head-to-head randomized controlled trials that compared blonanserin with risperidone for the treatment of schizophrenia. We extracted the following data: author, year, country, diagnostic criteria, sample size, course of treatment, dosage and outcomes. Our main endpoint was the changes in the Positive and Negative Syndrome Scale (PANSS) total scores. Meta-analysis of the included data was conducted by RevMan 5.3 software. We used the GRADE criteria to evaluate the certainty of the evidence. RESULTS A total of 411 studies were initially; 8 trials were eligible and were included in our analysis (N = 1386 participants). Regarding efficacy, there was no difference in changes in the PANSS total scores between the two groups (P > 0.05). In terms of safety, compared to risperidone, the incidence of serum prolactin increases and weight gain in the blonanserin group was lower (P<0.05), but the incidence of extrapyramidal symptoms (EPS) was higher (P<0.05). CONCLUSION The efficacy of blonanserin is similar to that of risperidone, but it is unclear whether blonanserin is more effective than risperidone at improving cognitive and social function. More high-quality studies are needed to verify the efficacy and safety of blonanserin in the future.
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Affiliation(s)
- Shu-Wen Deng
- College of Pharmacy, Qiqihar Medical University, Qiqihar, China
| | - Qian Xu
- The 8th Affiliated Hospital of Qiqihar Medical University, No.192 Rangdu Road, Ranghulu district, Daqing, Heilongjiang, China.
| | - Wen-Long Jiang
- The 8th Affiliated Hospital of Qiqihar Medical University, No.192 Rangdu Road, Ranghulu district, Daqing, Heilongjiang, China
| | - Bo Hong
- College of Pharmacy, Qiqihar Medical University, Qiqihar, China
| | - Bo-Hui Li
- The 8th Affiliated Hospital of Qiqihar Medical University, No.192 Rangdu Road, Ranghulu district, Daqing, Heilongjiang, China
| | - Da-Wei Sun
- The 8th Affiliated Hospital of Qiqihar Medical University, No.192 Rangdu Road, Ranghulu district, Daqing, Heilongjiang, China
| | - Hai-Bo Yang
- The 8th Affiliated Hospital of Qiqihar Medical University, No.192 Rangdu Road, Ranghulu district, Daqing, Heilongjiang, China
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