Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, SAR, China.
Int J Geriatr Psychiatry. 2013 Mar;28(3):305-11. doi: 10.1002/gps.3827. Epub 2012 May 7.
This study surveyed the use of anticholinergic medications (ACMs) in older Asian patients with schizophrenia and examined its demographic and clinical correlates.
A total of 1452 hospitalized patients with schizophrenia aged 55 years or older in nine Asian countries and territories were surveyed between 2001 and 2009. The cross-sectional data of patients' socio-demographic and clinical characteristics and the prescriptions of antipsychotic drugs and ACM were recorded using a standardized protocol and data collection procedure.
The frequency of ACM prescription was 64.6% in the pooled sample, with 72.4%, 61.9%, and 59.5% in 2001, 2004, and 2009, respectively. Multiple logistic regression analysis of the whole sample revealed that patients on ACM had a higher dose of antipsychotic medications, and were more likely to have extrapyramidal side effects and receive first-generation antipsychotic medications.
Anticholinergic medications were frequently used in older Asian patients with schizophrenia. Considering the potential side effects of ACM, the rationale for their widespread use in this patient population should be revisited.
本研究调查了年龄在 55 岁及以上的亚洲精神分裂症老年患者中抗胆碱能药物（ACMs）的使用情况，并探讨了其人口统计学和临床相关性。
2001 年至 2009 年间，在九个亚洲国家和地区共调查了 1452 名住院的 55 岁及以上精神分裂症患者。使用标准化协议和数据收集程序记录了患者的社会人口统计学和临床特征以及抗精神病药物和 ACM 的处方。
在汇总样本中，ACM 处方的频率为 64.6%，2001 年、2004 年和 2009 年分别为 72.4%、61.9%和 59.5%。对全样本进行的多变量逻辑回归分析显示，使用 ACM 的患者接受了更高剂量的抗精神病药物，并且更有可能出现锥体外系副作用和接受第一代抗精神病药物治疗。
在年龄较大的亚洲精神分裂症患者中，抗胆碱能药物经常被使用。考虑到 ACM 的潜在副作用，应该重新审视其在这一患者群体中广泛使用的合理性。
