Prescription of Antidementia Drugs and Antipsychotics for Elderly Patients in Japan: A Descriptive Study Using Pharmacy Prescription Data

J Geriatr Psychiatry Neurol. 2018 Jul;31(4):194-202. doi: 10.1177/0891988718785775. Epub 2018 Jul 17.

Abstract

Background: Antipsychotics are commonly used for managing behavioral and psychological symptoms of dementia among elderly patients with dementia receiving antidementia drugs (ADDs). However, the use of antipsychotics among these patients has not been investigated since 3 ADDs were approved in 2011 in Japan.

Method: We conducted a descriptive study using pharmacy prescription data and identified patients aged ≥65 years who were newly prescribed donepezil, memantine, rivastigmine, and galantamine between January 1, 2012, and September 30, 2014. We determined the proportion of antipsychotic prescription and the factors affecting antipsychotic prescription using multivariable Cox proportional hazard models.

Result: Of 13 876 patients, 1705 were memantine users, and the proportion of antipsychotic prescription among them was the highest (11.1%). Adjusted hazard ratios for donepezil, rivastigmine, and galantamine were 0.66, 0.56, and 0.66, respectively, relative to that for memantine.

Conclusion: Compared to other ADD users, new memantine users were most likely to be prescribed antipsychotics.

Keywords: antipsychotics; behavior and psychological symptoms of dementia; cholinesterase inhibitors; dementia; memantine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antipsychotic Agents / pharmacology
  • Antipsychotic Agents / therapeutic use*
  • Cholinesterase Inhibitors / pharmacology
  • Cholinesterase Inhibitors / therapeutic use*
  • Dementia / drug therapy*
  • Female
  • Humans
  • Japan
  • Male

Substances

  • Antipsychotic Agents
  • Cholinesterase Inhibitors