Antipsychotics use: 2006–2013 trends in prevalence and incidence and characterization of users
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The present study was conducted to describe antipsychotic (AP) prevalent and incident use, characteristics of AP users, and their trends in the French population.
A cross-sectional study was repeated yearly from January 1, 2007 to December 31, 2013 (for prevalence analysis) or to December 31, 2012 (for incidence analysis) using the French Health Insurance reimbursement database (Echantillon Généraliste de Bénéficiaires, EGB). For each year studied, prevalent and incident AP users were described in terms of age and gender overall, and according to the type of AP (FGAPs or SGAPs) used at index date. In addition, concurrent medications and comorbidities that a priori contraindicate the use of drugs having atropinic properties were researched.
Prevalence and incidence remained relatively stable along the 2007–2013 period. Trends slightly decreased, from 2.07% (n = 10,252) to 2.05% (n = 11,015) for prevalence, and from 0.73% (n = 3461) to 0.66% (n = 3363) for incidence, especially in elderly, in contrast of children and adolescents (+ 39% for prevalence, from 184 to 271). The number of coprescribed drugs was found high (median = 5) and remained constant over time. In 2013, about 7% of prevalent AP users presented with a comorbidity increasing the risk of atropinic ADRs, and 36% used at least one concurrent atropinic drug. In incident AP users, these numbers were of 8 and 29%, respectively.
The present study highlighted a marked shift from FGAPs toward SGAPs, as well as an increase in AP use in children and adolescents in France.
KeywordsPharmacoepidemiology Drug utilization Insurance health reimbursement Antipsychotics Prevalence Incidence
The present study is part of the Drugs Systematized Assessment in real-liFe Environment (DRUGS-SAFE) research programme. This programme aims at providing an integrated system allowing the concomitant monitoring of drug use and drug safety in France. It is funded by the French Agence Nationale de Sécurité du Médicament et des produits de santé (ANSM). This publication represents the views of the authors and does not necessarily that of the ANSM.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Rang HP, Dale MM, Ritter JM et al (2011) Rang & Dale’s Pharmacology, 7th edn. Churchill Livingstone, LondonGoogle Scholar
- 5.Carton L, Cottencin O, Lapeyre-Mestre M, Geoffroy P, Favre J, Simon N, Bordet R, Rolland B (2015) Off-label prescribing of antipsychotics in adults, children and elderly individuals: a systematic review of recent prescription trends. Curr Pharm Des 21(23):3280–3297. https://doi.org/10.2174/1381612821666150619092903 CrossRefPubMedGoogle Scholar
- 8.Aging Brain Care. Anticholinergic Cognitive Burden Scale—2012 Update. Available: www.agingbraincare.org/uploads/products/ACB_scale_-_legal_size.pdf
- 11.Nguyen TTH, Pariente A, Montastruc J-L, et al. An original pharmacoepidemiologic - pharmacodynamic method: application to antipsychotic-induced movement disorders. Br J Clin Pharmacol Published Online First: 30 September 2016. https://doi.org/10.1111/bcp.13145
- 12.Montastruc F, Palmaro A, Bagheri H, Schmitt L, Montastruc JL, Lapeyre-Mestre M (2015) Role of serotonin 5-HT2C and histamine H1 receptors in antipsychotic-induced diabetes: a pharmacoepidemiological-pharmacodynamic study in VigiBase. Eur Neuropsychopharmacol 25(10):1556–1565. https://doi.org/10.1016/j.euroneuro.2015.07.010 CrossRefPubMedGoogle Scholar
- 15.Jones DR, Macias C, Barreira PJ, Fisher WH, Hargreaves WA, Harding CM (2004) Prevalence, severity, and co-occurrence of chronic physical health problems of persons with serious mental illness. Psychiatr Serv 55(11):1250–1257. https://doi.org/10.1176/appi.ps.55.11.1250 CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Hugenholtz GWK, Heerdink ER, Stolker JJ, Meijer WE, Egberts ACG, Nolen WA (2006) Haloperidol dose when used as active comparator in randomized controlled trials with atypical antipsychotics in schizophrenia: comparison with officially recommended doses. J Clin Psychiatry 67(06):897–903. https://doi.org/10.4088/JCP.v67n0606 CrossRefPubMedGoogle Scholar
- 21.Tsai AC, Rosenlicht NZ, Jureidini JN, Parry PI, Spielmans GI, Healy D (2011) Aripiprazole in the maintenance treatment of bipolar disorder: a critical review of the evidence and its dissemination into the scientific literature. PLoS Med 8(5):e1000434. https://doi.org/10.1371/journal.pmed.1000434 CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Gallini A, Andrieu S, Donohue JM, Oumouhou N, Lapeyre-Mestre M, Gardette V (2014) Trends in use of antipsychotics in elderly patients with dementia: impact of national safety warnings. Eur Neuropsychopharmacol 24(1):95–104. https://doi.org/10.1016/j.euroneuro.2013.09.003 CrossRefPubMedGoogle Scholar