Skip to main content Accessibility help

Prescribing patterns of low doses of antipsychotic medications in older Asian patients with schizophrenia, 2001–2009

  • Yu-Tao Xiang (a1) (a2), Faith Dickerson (a3), Julie Kreyenbuhl (a4) (a5), Gabor S. Ungvari (a6), Chuan-Yue Wang (a2), Tian-Mei Si (a7), Edwin H. M. Lee (a1), Yan-Ling He (a8), Helen F. K. Chiu (a1), Kelly Y. C. Lai (a1), Naotaka Shinfuku (a9), Shu-Yu Yang (a10), Mian-Yoon Chong (a11), Ee-Heok Kua (a12), Senta Fujii (a13), Kang Sim (a14), Michael K. H. Yong (a14), Jitendra K. Trivedi (a15), Eun-Kee Chung (a16), Pichet Udomratn (a17), Kok-Yoon Chee (a18), Norman Sartorius (a19) and Chay-Hoon Tan (a12)...


Background: This study examined the use of low doses of antipsychotic medications (300 mg/day CPZeq or less) in older Asian patients with schizophrenia and its demographic and clinical correlates.

Methods: Information on hospitalized patients with schizophrenia, aged 55 years or older, was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study (2001–2009). Data on 1,452 patients in eight Asian countries and territories including China, Hong Kong, Japan, Korea, Singapore, Taiwan, India, and Malaysia were analyzed. Sociodemographic and clinical characteristics and antipsychotic prescriptions were recorded using a standardized protocol and data collection procedure.

Results: The prescription frequency for low doses of antipsychotic medications was 40.9% in the pooled sample. Multiple logistic regression analysis of the whole sample showed that patients on low doses of antipsychotic medications were more likely to be female, have an older age, a shorter length of illness, and less positive symptoms. Of patients in the six countries and territories that participated in all the surveys between 2001 and 2009, those in Japan were less likely to receive low doses of antipsychotics.

Conclusion: Low doses of antipsychotic medications were only applied in less than half of older Asian patients with schizophrenia.


Corresponding author

Correspondence should be addressed to: Dr. Yu-Tao Xiang, Department of Psychiatry, Chinese University of Hong Kong, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, N.T., Hong Kong. Phone: +852-2607-6041; Fax: +852-2647-5321. Email:
Dr. Tian-Mei Si, Peking University Institute of Mental Health, Beijing, China. Email:


Hide All
Alexopoulos, G. S., Streim, J., Carpenter, D. and Docherty, J. P. (2004). Using antipsychotic agents in older patients. Journal of Clinical Psychiatry, 65 (Suppl. 2), 599; discussion 100–102; quiz 103–104.
APA (1997). Practice Guideline for the Treatment of Patients with Schizophrenia. Washington, DC: American Psychiatric Press.
Barbui, C. et al. (2006). Persistence with polypharmacy and excessive dosing in patients with schizophrenia treated in four European countries. International Clinical Psychopharmacology, 21, 355362.
Chiu, H. F., Shum, P. S. and Lam, C. W. (1991). Psychotropic drug prescribing to chronic schizophrenics in a Hong Kong hospital. International Journal of Social Psychiatry, 37, 187191.
Chong, M. Y. et al. (2004). Antipsychotic drug prescription for schizophrenia in East Asia: rationale for change. Psychiatry and Clinical Neurosciences, 58, 6167.
Chow, L. Y., Ungvari, G. S., Chiu, H. F. K. and Leung, T. (1999). Psychotropic drug prescription for chronic psychiatric pateints in a long-stay care facility. Hong Kong Journal of Psychiatry, 9, 1520.
Frackiewicz, E. J., Sramek, J. J., Herrera, J. M., Kurtz, N. M. and Cutler, N. R. (1997). Ethnicity and antipsychotic response. Annals of Pharmacotherapy, 31, 13601369.
Ji, Z. F. (2005). Evaluation and analysis of drug-use in hospitals of China. Evaluation of Clinical Usage of Partial Dopamine Receptor Agonist, 5, 8991 [in Chinese].
Kane, J. M. et al. (1998). Guidelines for depot antipsychotic treatment in schizophrenia. European neuropsychopharmacology consensus conference in Siena, Italy. European Neuropsychopharmacology, 8, 5566.
Kohen, I., Lester, P. E. and Lam, S. (2010). Antipsychotic treatments for the elderly: efficacy and safety of aripiprazole. Neuropsychiatric Disease and Treatment, 6, 4758.
Kreyenbuhl, J., Buchanan, R. W., Dickerson, F. B. and Dixon, L. B. (2010). The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2009. Schizophrenia Bulletin, 36, 94103.
Lehman, A. F. et al. (2004). The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2003. Schizophrenia Bulletin, 30, 193217.
Masand, P. S. (2000). Side effects of antipsychotics in the elderly. Journal of Clinical Psychiatry, 61 (Suppl. 8), 4349.
Meyers, B. S. and Jeste, D. V. (2010). Geriatric psychopharmacology: evolution of a discipline. Journal of Clinical Psychiatry, 71, 14161424.
Okuma, T. (1981). Differential sensitivity to the effects of psychotropic drugs: psychotics vs normals; Asian vs Western populations. Folia Psychiatrica et Neurologica Japonica, 35, 7987.
Seeman, M. V. (2010). Schizophrenia: women bear a disproportionate toll of antipsychotic side effects. Journal of the American Psychiatric Nurses Association, 16, 2129.
Shinfuku, N. and Tan, C. H. (2008). Pharmacotherapy for schizophrenic inpatients in East Asia – changes and challenges. International Review of Psychiatry, 20, 460468.
Sim, K. et al. (2004). Antipsychotic polypharmacy in patients with schizophrenia: a multicentre comparative study in East Asia. British Journal of Clinical Pharmacology, 58, 178183.
Sim, K. et al. (2009). Low doses of antipsychotic drugs for hospitalized schizophrenia patients in East Asia: 2004 vs. 2001. International Journal of Neuropsychopharmacology, 12, 117123.
Uchida, H., Mamo, D. C., Mulsant, B. H., Pollock, B. G. and Kapur, S. (2009a). Increased antipsychotic sensitivity in elderly patients: evidence and mechanisms. Journal of Clinical Psychiatry, 70, 397405.
Uchida, H., Pollock, B. G., Bies, R. R. and Mamo, D. C. (2009b). Predicting age-specific dosing of antipsychotics. Clinical Pharmacology and Therapeutics, 86, 360362.
Ungvari, G. S., Chung, Y. G., Chee, Y. K., Fung-Shing, N., Kwong, T. W. and Chiu, H. F. (2002). The pharmacological treatment of schizophrenia in Chinese patients: a comparison of prescription patterns between 1996 and 1999. British Journal of Clinical Pharmacology, 54, 437444.
Woods, S. W. (2003). Chlorpromazine equivalent doses for the newer atypical antipsychotics. Journal of Clinical Psychiatry, 64, 663667.



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed