AUTHOR=Hori Hikaru , Yasui-Furukori Norio , Hasegawa Naomi , Iga Jun-ichi , Ochi Shinichiro , Ichihashi Kayo , Furihata Ryuji , Kyo Yoshitaka , Takaesu Yoshikazu , Tsuboi Takashi , Kodaka Fumitoshi , Onitsuka Toshiaki , Okada Tsuyoshi , Murata Atsunobu , Kashiwagi Hiroko , Iida Hitoshi , Hashimoto Naoki , Ohi Kazutaka , Yamada Hisashi , Ogasawara Kazuyoshi , Yasuda Yuka , Muraoka Hiroyuki , Usami Masahide , Numata Shusuke , Takeshima Masahiro , Yamagata Hirotaka , Nagasawa Tatsuya , Tagata Hiromi , Makinodan Manabu , Kido Mikio , Katsumoto Eiichi , Komatsu Hiroshi , Matsumoto Junya , Kubota Chika , Miura Kenichiro , Hishimoto Akitoyo , Watanabe Koichiro , Inada Ken , Kawasaki Hiroaki , Hashimoto Ryota TITLE=Prescription of Anticholinergic Drugs in Patients With Schizophrenia: Analysis of Antipsychotic Prescription Patterns and Hospital Characteristics JOURNAL=Frontiers in Psychiatry VOLUME=13 YEAR=2022 URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.823826 DOI=10.3389/fpsyt.2022.823826 ISSN=1664-0640 ABSTRACT=

In several clinical guidelines for schizophrenia, long-term use of anticholinergic drugs is not recommended. We investigated the characteristics of the use of anticholinergics in patients with schizophrenia by considering psychotropic prescription patterns and differences among hospitals. A cross-sectional, retrospective prescription survey at the time of discharge was conducted on 2027 patients with schizophrenia from 69 Japanese hospitals. We examined the relations among psychotropic drug prescriptions regarding anticholinergic prescription. We divided the hospitals into three groups—low rate group (LG), medium rate group (MG), and high rate group (HG)—according to their anticholinergic prescription rates, and analyzed the relationship between anticholinergic prescription rates and antipsychotic prescription. Anticholinergic drugs were prescribed to 618 patients (30.5%), and the prescription rates were significantly higher for high antipsychotic doses, antipsychotic polypharmacy, and first-generation antipsychotics (FGAs) use. The anticholinergic prescription rate varied considerably among hospitals, ranging from 0 to 66.7%, and it was significantly higher in patients with antipsychotic monotherapy, antipsychotic polypharmacy, and normal and high doses of antipsychotics in HG than in those LG and MG. The anticholinergics prescription rate in patients with second-generation antipsychotic monotherapy in HG was also significantly higher than in those LG and MG; however, the difference was no longer significant in patients with FGA monotherapy. Conclusively, in addition to high antipsychotic doses, antipsychotic polypharmacy, and FGA use, hospital characteristics influence the prescribing of anticholinergic drugs.