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Trends of Polypharmacy and Prescription Patterns of Antidepressants in Asia
Huang, Cho-Yin1; Yang, Shu-Yu2; Mojtabai, Ramin3; Lin, Shu-Ku1,4; He, Yan-Ling5; Chong, Mian-Yoon6,7; Ungvari, Gabor8; Tan, Chay-Hoon9; Xiang, Yu-Tao10; Sartorius, Norman11; Shinfuku, Naotaka12; Chen, Lian-Yu1,13


Little is known regarding the trend of polypharmacy in Asia. We used data from 5 Asian countries to examine the patterns of antidepressant (AD) prescription and trends of psychotropic polypharmacy over time.


We used the cross-sectional, pharmacoepidemiological data from 2004 and 2013 REAP-AD (Research on Asian Psychotropic Prescription Patterns for Antidepressants) to examine the patterns of AD prescriptions in clinical settings in China, Japan, Korea, Singapore, and Taiwan. We compared the trend in polypharmacy (ie, concomitant use of ≥2 classes of psychotropic) among individuals receiving AD prescriptions in 2004 and 2013 using multivariable logistic regression models in different diagnostic categories.


The proportion of patients with psychotropic polypharmacy decreased from 2004 to 2013 in all 3 diagnostic categories, including mood disorders (adjusted odds ratio [aOR], 0.44 [0.35–0.56]; P < 0.001), anxiety disorders (aOR, 0.58 [0.36–0.94]; P = 0.028), and psychotic disorders (aOR, 0.18 [0.05–0.60]; P = 0.006). Among individuals with AD prescriptions, concomitant use of anxiolytics (including sedative-hypnotics) decreased in patients with mood disorders (aOR, 0.34 [0.27–0.42]; P < 0.001) and anxiety disorders (aOR, 0.43 [0.27–0.67]; P < 0.001). In contrast, concomitant use of antipsychotics in patients with mood disorders increased (aOR, 1.43 [1.15–1.77]; P = 0.001), and concomitant use of mood stabilizers in patients with psychotic disorders also increased (aOR, 3.49 [1.50–8.14]; P = 0.004).


This is the first study examining trends in psychotropic polypharmacy in East Asia. We found a generally decreasing trend of psychotropic polypharmacy in contrast to the increasing trend reported from Western countries. These findings could offer significant implications for health system reform or policy making.

KeywordAntidepressant Use Polypharmacy Prescription Pattern
URLView the original
Indexed BySCI ; SSCI ; SSCI
WOS Research AreaPharmacology & Pharmacy ; Psychiatry
WOS SubjectPharmacology & Pharmacy ; Psychiatry
WOS IDWOS:000450084600011
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Cited Times [WOS]:1   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionFaculty of Health Sciences
Corresponding AuthorChen, Lian-Yu
Affiliation1.Taipei City Hosp, Dept Addict Psychiat, Taipei City Psychiat Ctr, 309,Songde Rd, Taipei, Taiwan;
2.Taipei City Hosp, Dept Pharm, Taipei City Psychiat Ctr, Taipei, Taiwan;
3.Johns Hopkins Bloomberg Sch Publ Hlth, Mental Hlth Dept, Baltimore, MD USA;
4.Taipei Med Univ, Dept Psychiat, Coll Med, Taipei, Taiwan;
5.Shanghai Mental Hlth Ctr, Dept Psychiat Epidemiol, Shanghai, Peoples R China;
6.Chang Gung Univ, Dept Psychiat, Kaohsiung Chang Gung Mem Hosp, Kaohsiung Med Ctr, Taoyuan, Taiwan;
7.Chang Gung Univ, Sch Med, Taoyuan, Taiwan;
8.Univ Western Australia, Sch Psychiat & Clin Neurosci, Nedlands, WA, Australia;
9.Natl Univ Singapore, Dept Pharmacol, Singapore, Singapore;
10.Univ Macau, Fac Hlth Sci, Macau, Macao SAR, Peoples R China;
11.Assoc Improvement Mental Hlth Programmes, Geneva, Switzerland;
12.Kobe Univ, Int Ctr Med Res, Med Res Ctr, Grad Sch Medicine, Kobe, Hyogo, Japan;
13.Natl Taiwan Univ, Inst Epidemiol & Prevent Med, Taipei, Taiwan
Recommended Citation
GB/T 7714
Huang, Cho-Yin,Yang, Shu-Yu,Mojtabai, Ramin,et al. Trends of Polypharmacy and Prescription Patterns of Antidepressants in Asia[J]. JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY,2018,38(6):598-603.
APA Huang, Cho-Yin.,Yang, Shu-Yu.,Mojtabai, Ramin.,Lin, Shu-Ku.,He, Yan-Ling.,...&Chen, Lian-Yu.(2018).Trends of Polypharmacy and Prescription Patterns of Antidepressants in Asia.JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY,38(6),598-603.
MLA Huang, Cho-Yin,et al."Trends of Polypharmacy and Prescription Patterns of Antidepressants in Asia".JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY 38.6(2018):598-603.
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