Antipsychotic prescribing trends: A review of pharmacoepidemiological studies

INSERM U657, Université Victor Segalen Bordeaux2, Bordeaux Cedex, France.
Acta Psychiatrica Scandinavica (Impact Factor: 5.55). 01/2010; 121(1):4-10. DOI: 10.1111/j.1600-0447.2009.01425.x
Source: PubMed

ABSTRACT To review findings from pharmaco-epidemiological studies exploring antipsychotic (AP) drugs prescribing trends.
We retrieved original studies that explored AP prescribing trends in general population samples since 2000. For each study, we extracted information on sampling method, period, assessment of AP use and corresponding estimates (incidence rates, prevalence rates, pharmacy sales, prescription data) and diagnostic assessment.
Nearly all studies meeting the inclusion criteria (n = 17) showed an increase in AP prescriptions, mainly because of a dramatic rise in second-generation antipsychotics (SGAP) prescriptions. APs are often prescribed for non-psychotic disorders in adults as well as in children and adolescents.
Considering the growing number of persons from the general population exposed to APs, population studies assessing the risk/benefit ratio of SGAP use in disorders other than psychosis are necessary, particularly in children and adolescents.

  • Source
    • "A fine-grained analysis is important for elucidating the specific action mechanisms of different therapeutic strategies, especially cognitive-behavioral therapy (CBT) or antipsychotic treatment in psychosis. This is especially crucial as the prescription of antipsychotic drugs has largely increased during the last decade (Verdoux et al., 2010). For example, Kapur and colleagues (Kapur, 2003; Kapur et al., 2005, 2006) proposed that antipsychotic treatment affects delusions and hallucinations primarily by making them less important and less " salient " , not by changing their appearance and contents. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The Psychiatric Symptom Rating Scales (PSYRATS) have demonstrated their usefulness for the dimensional assessment of hallucinations and delusions. However, there is no evaluated German version of the PSYRATS to date. Also, in spite of theoretical conceptions about "detaching" effects of antipsychotics, there are few consolidated findings about how core symptomatic aspects of schizophrenia change during antipsychotic treatment. The present study aimed to fill this gap. A total of 40 schizophrenic voice-hearers were interviewed three times during the course of six months using a newly developed German version of the PSYRATS with very good psychometric properties. At the same time, psychopathology was assessed with the Positive and Negative Syndrome Scale (PANSS). In the longitudinal course, a general symptomatic decrease became apparent only for auditory hallucinations but not for delusions. Specifically, the loudness of the hallucinated voices as well as the associated distress decreased early, while other aspects of the hallucinations took more time to fade. In this study, the PSYRATS proved to be a valuable tool for measuring the change of specific symptom dimensions. However, our results only partially supported the notion of a general detachment from symptoms due to psychiatric treatment.
    Psychiatry Research 06/2011; 188(1):13-7. DOI:10.1016/j.psychres.2010.12.013 · 2.68 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: It has been informally observed that patients attending urology clinics specializing in overactive bladder and incontinence have high rates of psychiatric conditions. Hence, the evolution of the term “uropsychiatry” that describes the association between overactive bladder and incontinence with common psychiatric conditions including depression, anxiety, and sexual abuse. Epidemiologic and case-control studies have established links between these conditions. In addition, basic science and clinical pharmacologic studies of antidepressants and atypical antipsychotics provide evidence that dysregulation of neurotransmitters including norepinephrine, serotonin, and corticotropin releasing factor may be important in the pathophysiology underlying uropsychiatric disorders. Improved understanding of these complex interactions may help in the identification of novel targets that lead to improved treatments for patients with both urologic and psychiatric conditions.
    Current Bladder Dysfunction Reports 03/2012; 8(1). DOI:10.1007/s11884-012-0164-5
  • Source
Show more