Prescription Pattern of Atypical Antipsychotics in a University Psychiatric Ward: 11-Year Observational Study

Sung Yeol Park; Sangho Shin; Euitae Kim

doi:10.16946/kjsr.2016.19.2.68

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Park, Shin, and Kim: Prescription Pattern of Atypical Antipsychotics in a University Psychiatric Ward: 11-Year Observational Study

Original Article

Korean J Schizophr Res 2016;19(2):68-77.

Published online: 20 January 2016

DOI: https://doi.org/10.16946/kjsr.2016.19.2.68

Prescription Pattern of Atypical Antipsychotics in a University Psychiatric Ward: 11-Year Observational Study

Sung Yeol Park, MD¹, Sangho Shin, MD², Euitae Kim, MD^2,

¹Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea

²Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea

Address for correspondence: Euitae Kim, Department of Neuropsychiatry, Seoul National University Bundang Hospital, 82 Gumi-ro 173 beon-gil, Bun-dang-gu, Seongnam 13620, Korea Tel: 031-787-7435, Fax: 031-787-4058 E-mail: euitae.kim@gmail.com

Received 5 October 2016 Revised 12 October 2016 Accepted 14 October 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

This study investigated the prescribing patterns of atypical antipsychotics for the various psychiatric disorders in the psychiatric ward of a University hospital.

Methods

We reviewed the medical records of patients who were discharged from an open psychiatric ward from May, 2003 through April, 2014. The association between psychiatric disorders and prescription pattern of atypical antipsychotics was analyzed.

Results

: The study included 3091 patients' prescription of psychiatric medication. 60% of prescription included antipsychotics; quetiapine was the most frequently prescribed antipsychotics, but the average dosage was the lowest among all the atypical antipsychotics. According to the diagnoses, prescription rates and dosage of antipsychotics were different. Prescription rates of antipsychotics were the lowest in patients with anxiety disorders, and the mean dosage were the lowest in those with delirium, dementia, and amnestic and other cognitive disorders.

Conclusion

This observational study shows prescription patterns of atypical antipsychotics for the treatment of psychiatric disorders in a University hospital; atypical antipsychotics were widely used for the treatment of the various disorders, and there were differences in prescription patterns for each disorders. The results of this study may be used to identify the proper atypical antipsychotics effective on certain psychiatric disorders and to propose expanding the indications of each atypical antipsychotics in the future.

Keywords: Atypical antipsychotics, Prescription pattern, Psychiatric ward, Off-label.

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Fig. 1.

진단 분포: 우울장애 1111명(36%), 양극성장애 918명(30%), 조현 병 및 정신병적 장애 231명(8%), 불안장애 197명(6%), 신경인지장애 187 명(6%), 기타 진단군 447명(14%).

Fig. 2.

입원 연도별 항정신병제 처방 빈도.

Fig. 3.

연도별 1인당 평균 항정신병제 처 방 용량(chloropromazine 등가용량). ∗: 평균 처방 용량 계산에는 항정신병 제를 처방받은 환자만을 포함시킴.

Fig. 4.

진단별 1인당 평균 항정신병제 처방 용량(chloropromazine 등가용 량). ∗: 평균 처방 용량 계산에는 항정 신병제를 처방받은 환자만을 포함시킴.

Fig. 5.

진단별 항정신병제 처방 빈도.

Fig. 6.

진단별 1인당 항정신병제 평균 처방 용량(Chloropromazine 등가용량). ∗: 평균 처방 용량 계산에는 항정신병제를 처방받은 환자만을 포함시킴.

	전 체		우울장애		양극성장애		정신병적 장애		불안장애		신경인지장애		기 타
	(n=3091)		(n=1111)		(n=918)		(n=231)		(n=197)		(n=187)		(n=447)
	n	%	n	%	n	%	n	%	n	%	n	%	n	%
성멸
F	2094	67.75	826	74.35	652	71.02	121	52.38	109	55.33	112	59.89	274	61.3
M	997	32.25	285	25.65	266	28.98	110	47.62	88	44.67	75	40.11	173	38.7
나이
평균±SD	51.68	±20.40	60.07	±18.53	42.65	±15.58	37.41	±16.00	45.26	±16.90	771	14.26	48.91	±20.99
결혼상대
기혼	1739	56.26	752	67.69	451	49.13	63	27.27	111	56.35	120	64.17	242	54.14
미혼	845	27.34	137	12.33	359	39.11	148	64.07	59	29.95	10	5.35	132	29.53
이혼	100	3.24	28	2.52	47	5.12	4	1.73	6	3.05	2	1.07	13	2.91
별거	30	0.97	12	1.08	6	0.65	1	0.43	2	1.02	2	1.07	7	1.57
사별	221	7.15	133	11.97	17	1.85	6	2.6	7	3.55	37	19.79	21	4.7
미상	156	5.05	49	4.41	38	4.14	9	3.9	12	6.09	16	8.56	32	7.16
직업
주부	1040	33.65	508	45.72	273	29.74	37	16.02	44	22.34	57	30.48	121	27.07
무직	672	21.74	209	18.81	199	21.68	80	34.63	25	12.69	85	45.45	74	16.55
학생	464	15.01	94	8.46	174	18.95	70	30.3	32	16.24	3	1.6	91	20.36
자유업	198	6.41	68	6.12	65	7.08	6	2.6	27	13.71	8	4.28	24	5.37
회사원	159	5.14	52	4.68	54	5.88	8	3.46	13	6.6	1	0.53	31	6.94
전문직	139	4.5	51	4.59	44	4.79	6	2.6	18	9.14	4	2.14	16	3.58
군인	32	1.04	8	0.72	9	0.98	4	1.73	5	2.54	2	1.07	4	0.89
기타	211	6.83	70	6.3	56	6.1	10	4.33	20	10.15	8	4.28	47	10.51
미상	176	5.69	51	4.59	44	4.79	10	4.33	13	6.6	19	10.16	39	8.72
SES
상	340	11	115	10.35	106	11.55	21	9.09	26	13.2	20	10.7	52	11.63
중	2054	66.45	775	69.76	600	65.36	154	66.67	128	64.97	109	58.29	288	64.43
하	153	4.95	55	4.95	40	4.36	23	9.96	8	4.06	7	3.74	20	4.47
미상	544	17.6	166	14.94	172	18.74	33	14.29	35	17.77	51	27.27	87	19.46
이전 정신과 입원력
평균±SD	0.44	±1.22	0.29	±0.89	0.69	±1.56	0.49	±1.13	0.32	±0.86	0.36	±0.83	0.33	±1.35
입원 연도
2003	96	3.11	25	2.25	39	4.25	1	0.43	5	2.54	9	4.81	17	3.8
2004	223	7.21	75	6.75	72	7.84	11	4.76	17	8.63	25	13.37	23	5.15
2005	236	7.64	90	8.1	68	7.41	14	6.06	17	8.63	21	11.23	26	5.82
2006	266	8.61	77	6.93	87	9.48	30	12.99	17	8.63	16	8.56	39	8.72
2007	272	8.8	98	8.82	95	10.35	20	8.66	11	5.58	7	3.74	41	9.17
2008	265	8.57	101	9.09	73	7.95	20	8.66	15	7.61	18	9.63	38	8.5
2009	251	8.12	86	7.74	77	8.39	15	6.49	14	7.11	13	6.95	46	10.29
2010	290	9.38	113	10.17	86	9.37	25	10.82	17	8.63	20	10.7	29	6.49
2011	307	9.93	129	11.61	83	9.04	22	9.52	16	8.12	13	6.95	44	9.84
2012	349	11.29	111	9.99	114	12.42	23	9.96	27	13.71	18	9.63	56	12.53
2013	443	14.33	168	15.12	109	11.87	39	16.88	33	16.75	22	11.76	72	16.11
2014	93	3.01	38	3.42	15	1.63	11	4.76	8	4.06	5	2.67	16	3.58
재원일수
평균±SD	25.35	±34.33	21.96	±28.78	29.63	±36.54	35.32	±51.62	27.72	±53.19	26.26	±23.64	18.44	±18.48

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