Gender differences in the use of atypical antipsychotics in early-onset schizophrenia: a nationwide population-based study in Brazil

BackgroundThe use of atypical antipsychotics for the treatment of schizophrenia and other mental disorders in populations under 18years of age is increasing worldwide. Little is known about treatment patterns and the influence of gender differences, which may be a predictor of clinical outcomes. The aim of this study was to investigate gender differences in the use of atypical antipsychotics in patients with early-onset schizophrenia (EOS) assisted by the public health system in Brazil.MethodsWe conducted a cross-sectional study of outpatients with EOS aged 10 to 17years who received at least one provision of atypical antipsychotics (clozapine, olanzapine, risperidone, quetiapine or ziprasidone) from a large Brazilian pharmaceutical assistance programme. Data were retrieved from a nationwide administrative database from 2008 to 2017.ResultsOf the 49,943 patients with EOS, 63.5% were males, and the mean age was 13.6years old. The patients were using risperidone (62.5%), olanzapine (19.6%), quetiapine (12.4%), ziprasidone (3.3%) and clozapine (2.2%). We found gender differences, especially in the 13-17year age group (65.1% for males vs. 34.9% for females, p<0.001), in the use of risperidone (72.1% for males vs. 27.9% for females, p<0.001) and olanzapine (66.5% for males vs. 33.5% for females, p<0.001). Only in the 13 to 17years age group were the prescribed doses of olanzapine (p=0.012) and quetiapine (p=0.041) slightly higher for males than for females.ConclusionsOur findings showed gender differences among patients diagnosed with EOS and who received atypical antipsychotics. More attention should be devoted to gender differences in research and clinical practice.

Automated summary

The study revealed gender differences in the use of atypical antipsychotics among patients diagnosed with early-onset schizophrenia, with males more commonly using risperidone and olanzapine in the 13-17 age group. Male patients were prescribed slightly higher doses of olanzapine and quetiapine in the 13-17 age group. More attention should be given to gender differences in both research and clinical practice.