Yasui-Furukori Norio, Kawamata Yasushi, Sasaki Taro, Yokoyama Saaya, Okayasu Hiroaki, Shinozaki Masataka, Takeuchi Yoshitaka, Sato Aoi, Ishikawa Takaaki, Komahashi-Sasaki Hazuki, Miyazaki Kensuke, Fukasawa Takashi, Furukori Hanako, Sugawara Norio, Shimoda Kazutaka
Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan.
Department of Psychiatry, TMC Shimotsuga, Tochigi, Japan.
Neuropsychiatr Dis Treat. 2023 Apr 17;19:921-928. doi: 10.2147/NDT.S390482. eCollection 2023.
Recent pharmacoepidemiology data show an increase in the proportion of patients receiving second-generation antipsychotic (SGA) monotherapy, but no studies have analyzed the same patients over a long period of time. Therefore, in this study, we retrospectively evaluated schizophrenia patients with available data for 20 years to determine whether the drug treatments in the same patients have changed in the past 20 years.
The study began in April 2021 and was conducted in 15 psychiatric hospitals in Japan. Schizophrenia patients treated in the same hospital for 20 years were retrospectively examined for all prescriptions in 2016, 2011, 2006, and 2001 (ie, every 5 years).
The mean age of the 716 patients surveyed in 2021 was 61.7 years, with 49.0% being female. The rate of antipsychotic monotherapy use showed a slight increasing trend over the past 20 years; the rate of SGA use showed a marked increasing trend from 28.9% to 70.3% over the past 20 years, while the rate of SGA monotherapy use showed a gradual increasing trend over the past 20 years. The rates of concomitant use of anticholinergics, antidepressants, anxiolytics/sleep medications, and mood stabilizers showed decreasing, flat, flat, and flat trends over the past 20 years, respectively.
The results of this study showed a slow but steady substitution of SGAs for first-generation antipsychotics (FGAs) over time, even in the same patients.
近期的药物流行病学数据显示，接受第二代抗精神病药物（SGA）单药治疗的患者比例有所增加，但尚无研究对同一批患者进行长期分析。因此，在本研究中，我们对有20年可用数据的精神分裂症患者进行了回顾性评估，以确定同一批患者在过去20年中的药物治疗是否发生了变化。
该研究于2021年4月开始，在日本的15家精神病医院进行。对在同一家医院接受了20年治疗的精神分裂症患者的2016年、2011年、2006年和2001年（即每5年）的所有处方进行回顾性检查。
2021年调查的716例患者的平均年龄为61.7岁，女性占49.0%。抗精神病药物单药治疗的使用率在过去20年中呈轻微上升趋势；SGA的使用率在过去20年中从28.9%显著上升至70.3%，而SGA单药治疗的使用率在过去20年中呈逐渐上升趋势。抗胆碱能药物、抗抑郁药物、抗焦虑/助眠药物和心境稳定剂的联合使用比例在过去20年中分别呈下降、持平、持平和平平的趋势。
本研究结果表明，随着时间的推移，即使在同一批患者中，SGA也在缓慢但稳步地替代第一代抗精神病药物（FGA）。
