4.6 Article

Hypnotic medication use among inpatients with schizophrenia and major depressive disorder: results of a nationwide study

Journal

SLEEP MEDICINE
Volume 89, Issue -, Pages -

Publisher

ELSEVIER
DOI: 10.1016/j.sleep.2021.11.005

Keywords

Hypnotic medication; Schizophrenia; Major depressive disorder; Insomnia; Antipsychotic; Antidepressant

Funding

  1. Japan Agency for Medical Research and Development (AMED) [JP16dk0307060]
  2. AMED [JP19dk0307083]
  3. Health and Labor Sciences Research Grants [H29-SeishinIppan-001, 19GC1201]
  4. Japanese Society of Neuropsychopharmacology
  5. Japanese Society of Clinical Neuropsychopharmacology
  6. Japan Society for Promoting Science and Technology Agency [20K07967, 2020e2022]
  7. Japanese Society of Mood Disorders

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Prescription of hypnotic agents is highly frequent among inpatients with psychiatric disorders, especially those with schizophrenia and major depressive disorder. The use of two or more antipsychotic agents is commonly associated with the use of hypnotic medication.
Study objectives: To investigate the proportion of inpatients with schizophrenia and major depressive disorder prescribed hypnotic medication, and the association between such medication and the use of other antipsychotic agents. Methods: This was a nationwide cross-sectional study performed as part of the 'Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment' (EGUIDE) project. Data from 2146 inpatients with schizophrenia and 1031 inpatients with major depressive disorder were analyzed. All types and dosages of psychotropic drugs were recorded and the data at the time of discharge were analyzed. Associations between the use of hypnotic medication and other antipsychotic agents were evaluated using multivariate logistic regression analyses. Results: The proportions of schizophrenia patients who were prescribed any and two or more hypnotic agents were 55.7% and 17.6%, respectively, and the corresponding proportions for patients with major depressive disorder were 63.6% and 22.6%, respectively. In schizophrenia patients, multivariate logistic regression analyses showed that two or more antipsychotics, anticholinergic drugs, anxiolytics, and mood stabilizers/antiepileptic drugs were positively associated with the use of any hypnotic agent. In patients with major depressive disorder, multivariate logistic regression analyses revealed that two or more antidepressants, two or more antipsychotics, anxiolytics, and mood stabilizers/antiepileptic drugs were positively associated with the use of any hypnotic agent. Conclusions: Prescription of hypnotic agents was found to be highly frequent among inpatients with psychiatric disorders. Prescription of two or more main antipsychotic agents was commonly associated with the use of hypnotic medication for both schizophrenia and major depressive disorder. (C) 2021 Elsevier B.V. All rights reserved.

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