Incident users of antipsychotics: who are they and how do they fare?
Soc Psychiatry Psychiatr Epidemiol
; 51(4): 505-12, 2016 Apr.
Article
em En
| MEDLINE
| ID: mdl-26409887
ABSTRACT
PURPOSE:
In Denmark, as well as in many other countries, consumption of antipsychotics is on the rise, partly due to increasing off-label use. The aim of this study was to analyze and quantify the extent of off-label use and polypharmacy in incident users of antipsychotic medication, and to examine initial antipsychotic prescribing patterns and associated use of mental health care services.METHOD:
Population-based cohort study linking the following Danish national registers the Central Psychiatric Research Register, the Register of Medicinal Product Statistics, and Statistics Denmark.RESULTS:
From 2007 to 2012, 154,351 Danish subjects initiated treatment with antipsychotics. Among these, 71,254 (46 %) subjects had a psychiatric diagnosis recorded. The most frequent diagnoses were reaction to severe stress and adjustment disorders (10,106; 14 %), depressive episode (8876; 12 %), and recurrent depressive disorder (6810; 10 %). We found high antipsychotic discontinuation rates during the first few months (45 % in 4 months) and frequent antidepressant co-prescribing from treatment onset (47 %). Significantly greater likelihood of psychiatric hospitalization was observed for antipsychotic polypharmacy (HR 1.38; 95 % CI 1.32-1.45), whereas antipsychotic discontinuation was associated with decreased hospitalization risk in most off-label conditions.CONCLUSIONS:
The brief duration of most antipsychotic prescriptions suggests that antipsychotics are prescribed more liberally than recommended. As a consequence of the range of adverse effects associated with antipsychotic drug use, the documented widespread off-label prescribing practices warrant careful monitoring for adverse effects and prompt discontinuation in case of an unfavorable risk-benefit ratio.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Antipsicóticos
/
Padrões de Prática Médica
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Polimedicação
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Uso Off-Label
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Hospitalização
/
Transtornos Mentais
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Serviços de Saúde Mental
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Soc Psychiatry Psychiatr Epidemiol
Assunto da revista:
CIENCIAS SOCIAIS
/
EPIDEMIOLOGIA
/
PSIQUIATRIA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Dinamarca