Research on Asian Prescription Patterns (REAP): Focusing on Data from Japan

亞洲地區處方藥物型態的研究：著重於日本的資料

新福尚隆(Shinfuku Naotaka)

精神分裂症 ； 抗精神病藥物 ； 複方用藥 ； 抗憂鬱劑 ； schizophrenia ； antipsychotic drugs ； polypharmacy ； antidepressants

台灣精神醫學

28卷2期（2014 / 06 / 01）

i+71 - 85

英文

自從2001年起，亞洲地區的精神科醫師合作完成了各國開立精神科藥物之型態的研究（Research on Asia Psychotropic Prescription Pattern, REAP）。2001年至2004年參與的國家包括中國、香港、日本、南韓及台灣等五國或地區，2008年起印度、馬來西亞、泰國也加入了這項研究。每位研究者用當初協議好統一的問卷收集了超過6,000位精神分裂症病人的處方（即2001、2004、2008，每年各約2,000名）並拿來分析及比較。結果發現日本的處方與其他國家相比有明顯的高劑量及複方用藥的特性；且特定藥物的可用性在國與國之間差異極大；另外各亞洲國家在2001年到2008年期間處方的藥物大多從第一代抗精神病藥物轉移成第二代抗精神病藥物，而這些改變也伴隨著副作用及其他精神科用藥使用上的變化，這些結論已經刊登在超過30篇國際期刊上。2004年REAP的成員也開始探究抗憂鬱劑的處方型態，並在2013年做了追蹤，2013年的研究擴展到10個國家參與，包括40個精神機構中超過200位精神科醫師共同完成了追蹤。REAP的目標在於促進亞洲地區已開發及開發中國家精神科的合作，且REAP有潛力增進參與研究國家精神科用藥的處方型態。

Since 2001, Asian psychiatrists have carried out collaborative research on the prescription patterns of psychotropic drugs in Asia (REAP). Investigators, who participated in the survey in 2001 and 2004, were from China, Hong Kong, Japan, Korea, Singapore, and Taiwan. In 2008, investigators from India, Malaysia, and Thailand also joined this research. All investigators collected the data based on a unified questionnaire-based research protocol. More than 6,000 prescriptions of schizophrenic inpatients, (around 2,000 prescriptions each in 2001, 2004, and 2008), were analyzed and compared. The results have yielded that Japan has notable high-dose antipsychotic prescription and high frequency of polypharmacy than other participating countries and areas, that the availability of particular drugs differs greatly from country to country, and that there has been a major shift in the prescriptions from first-generation antipsychotics (FGAs) to second-generation antipsychotics (SGAs) in all participated Asian countries from 2001 to 2008. This shift has been accompanied by changes in side effects and by the use of other psychotropic drugs. These findings have been reported in more than 30 international journals. In 2004, REAP members surveyed the prescription patterns of antidepressants and did a follow up survey in 2013. More than 200 psychiatrists of 40 psychiatric institutions from 10 countries and areas in Asia participated in the recently concluded 2013 survey. The goal of REAP has been to improve prescription patterns of psychotropic drugs in those participated Asian countries. REAP has potential to promote collaborative research in psychiatry among developed and developing countries in Asia.

1. Chong, MY,Tan, CH,Fujii, S(2004).Antipsychotic drug prescription for Schizophrenia in East Asia: a rationale for change.Psychiatry Clin Neurisci,58,61-4.
2. Fujii, S、Kaneko, N、Kitsukawa, H(2005)。Prescription of antidepressants in Japan: finding from international collaboratinve study on the prescription of antidepressantgs in fi ve countreis and aeas in Asia。Japanese Journal of Social Psychiatry，14，30-5。
3. Fujii, S、Maeda, K、Shinfuku, N(2003)。International collaborative studies on the prescription of antipsychotics in East Asia: fi nding from Research on East Asia Psychotropic Prescription Pattern。Rinsyou Seishin Igaku，32，629-46。
4. Fujii, S、Shinfuku, N(2005)。Historical overview on the use of levomepromazine in Japan and the setting of its dose in pharmacotherapy。Rinsyou Seishin Yakuri，8，1127-38。
5. Inagaki, A(2003)。Polypharmacy of antipsychotics in Japan: comparaison between Japan and foreign countries。Seishinnka Chiryougaku，18，771-7。
6. Inagaki, A、Inada, T、Fujii, Y(1999)。Dose Equivalence of Psychotropic Drugs。Tokyo:Seiwa Syoten。
7. Ishigooka, Jed.、Okazaki, Yed.、Higuchi, Ted.(2011)。New Strategies of Treatment of Schizophrenia。Tokyo:Sentann Igakusya。
8. Ito, H,Okumura, Y,Higuchi, T(2012).International variation in antipsychotic prescribing for schizophre nia: pooled results from the research on East Asia psychotropic prescription (REAP) studies.Open Journal of Psychiatry,2,340-6.
9. Kanba, Sed.、Kuroki, Ted.(2009)。Clinics of Depression at Present。Tokyo:Sougen-sya。
10. Kazamatsuri, H(1997)。Psychotropic drug therapy of patients in mental hospitals in Japan: the present status and problems。Seishin Shinkei Shi，99，802-15。
11. Miyamoto, S、Morokawa, Y(2006)。Current situation of pharmacotherapy for schizophrenia in Japan: how to break away from poly-pharmacy and high dose prescription。Rinsyou Seishin Yakuri，9，2177-87。
12. Murasaki, M(2001)。Current situation and prospect of psychopharmacotherapy in Japan: toward the 21st century。Rinsyou Seishinn Yakuri，4，3-27。
13. Nakano, W、Fujii, S、Shinfuku, N(2011)。Changes of prescription pattern for schizophrenic inpatients in Asia over the past 10 years fi nding from Research on Asian Psychotropic Prescription Pattern。Rinsyou Seishinn Yakuri，14，1397-411。
14. Nakano, W、Yang, SY、Fujii, S(2010)。Characteristics of pharmacotherapy for schizophrenic inpatients in Japan: Findings from Research on East Asia Psychotropic Prescription Pattern of Antipsychotics。Rinsyou Seishin Yakuri，13，103-3。
15. Shinfuku, N,Tan, CH(2008).Pharmacotherapy for schizophrenic inpatients in East Asia: changes and challenges.Int Rev Psychiatry,20,460-8.
16. Shinfuku, N,Wang, XD,Chen, T(2000).Epidemiology of mood disorders from an international perspective: with special reference to Asian countries.Singapore Med J,41,10-5.
17. Sim, K,Chuan, Suh,Fujii, S(2008).Low dose of antipsychotic drugs for hospitalised schizophrenia patients in East Asia: 2004 vs. 2001.Int J Neuropsychopharmacol,12,117-23.
18. Sim, K,Lee, NB,Chua, HC(2007).Newer antidepressant drug use in East Asian psychiatric treatment settings: REAP (Research on East Asia Psychotropic Prescriptions) Study.Br J Clin Pharmacol,63,431-7.
19. Sim, K,Su, A,Chan, YH(2004).Clinical correlates of antipsychotic polytherapy in patients with schizophrenia in Singapore.Psychiatry Clin Neurosci,58,324-9.
20. Sim, K,Su, A,Fujii, S(2004).Antipsychotic polypharmacy in patients with schizophrenia: a multicenter comparative study in East Asia.Br J Clin Pharmacol,58,178-83.
21. Sim, K,Su, A,Leong, JY(2004).High dose antipsychotic use in schizophrenia: fi ndings of the REAP (Research on East Asia Psychotropic Prescriptions) study.Pharmacopsychiatry,37,175-9.
22. Sim, K,Su, A,Ungvari, GS(2004).Depot antipsychotic use in schizophrenia: an East Asian perspective.Hum Psychopharmacol,19,103-9.
23. Sim, K,Su, HC,Fujii, S(2009).High-dose antipsychotic use in schizophrenia: a comparison between the 2001 and 2004 Research on East Asia Psychotropic Prescription (REAP) studies.Br J Clin Pharmacol,67,110-7.
24. Sim, K,Yong, KH,Chan, YH(2011).Adjunctive mood stabilizer treatment for hospitalized schizophrenia patients: Asia psychotropic prescription study (2001-2008).Int J Neuropsychopharmacol,14,1157-64.
25. Takahashi, T、Nagamine, M、Shinfuku, N(2009)。Survey on the psychiatric diagnoses (ICD and DSM) in Chian,Japan, Korea and Taiwan。Seishin Igaku，51，129-35。
26. Tan, C.H(2000).New Challenges in psychopharmacology.Singapore Med J,41,3-4.
27. Tan, CH,Shinfuku, N,Sim, K(2008).Psychotropic prescription practices in East Asia: looking back and seering ahead.Curr Opin Psychiatry,21,645-50.
28. Tanaka, M、Nagai, H、Uchida, N(2007)。Current situation on the prescription of antidepressants in East Asia: findings from REAP collaborative surveys in five countries and areas。Rinsyouseishin Yakuri，10，131-46。
29. Tor, PC,Ng, TP,Yong, KH(2011).Adjunctive benzodiazepine treatment of hospitalized schizophrenia patients in Asia from 2001 to 2008.Int J Neuropsychopharmacol,14,735-45.
30. Uchida, N,Chong, MY,Tan, CH(2007).International study on antidepressant prescription pattern at 20 teaching hospitals and major psychiatric institutions in East Asia: Analysis of 1898 cases from China, Japan, Korea, Singapore and Taiwan.Psychiatry Clin Neurosci,61,522-8.
31. WHO(2000).WHO: ATC index with DDDs..Oslo:Collaborating Center for Drug Statistic Methodology.
32. Woods, SW(2003).Chlorpromazine equivalent doses for the newer atypical antipsychotics.J Clin Psychiatry,64,663-7.
33. Xiang, YT,Buchanan, RW,Ungvari, GS(2013).Use of clozapine in older Asian patients with schizophrenia between 2001 and 2009.PLoS One,8,e66154.
34. Xiang, YT,Dickerson, F,Kreyenbuhl, J(2012).Prescribing patterns of low doses of antipsychotic medications in older Asian patients with schizophrenia, 2001-2009.Int Psychogeriatr,24,1002-8.
35. Xiang, YT,Dickerson, F,Kreyenbuhl, J(2012).Adjunctive mood stabilizer and benzodiazepine use in older Asian patients with schizophrenia, 2001-2009.Pharmacopsychiatry,45,217-22.
36. Xiang, YT,Dickerson, F,Kreyenbuhl, J(2013).Common use of anticholinergic medications in older patients with schizophrenia: fi ndings of the Research on Asian Psychotropic Prescription Pattern (REAP) study, 2001-2009.Int J Geriatr Psychiatry,28,305-11.
37. Xiang, YT,Dickerson, F,Kreyenbuhl, J(2012).Common use of antipsychotic polypharmacy in older Asian patients with schizophrenia (2001-2009).J Clin Psychopharmacol,32,809-13.
38. Xiang, YT,Kreyenbuhl, J,Dickerson, FB(2012).Antipsychotic treatment in older schizophrenia patients with extrapyramidal side effects in Asia (2001-2009).Int J Clin Pharmacol Ther.,50,500-4.
39. Xiang, YT,Kreyenbuhl, J,Dickerson, FB(2012).Use of fi rst- and second-generation antipsychotic medications in older patients with schizophrenia in Asia (2001-2009).Aust N Z J Psychiatry,46,1159-64.
40. Xiang, YT,Li, Y,Correll, CU,Ungvari, GS(2013).Common use of high doses of antipsychotic medications in older Asian patients with schizophrenia (2001-2009).Int J Geriatr Psychiatry
41. Xiang, YT,Ungvari, GS,Wang, CY(2013).Adjunctive antidepressant prescriptions for hospitalized patients with schizophrenia in Asia (2001-2009).Asia Pac Psychiatry,5,E81-7.
42. Xiang, YT,Wang, CY,Si, TM(2011).Tardive dyskinesia in the treatment of schizophrenia: the fi ndings of the Research on Asian Psychotropic Prescription Pattern (REAP) survey (2001-2009).Int J Clin Pharmacol Ther,49,382-7.
43. Xiang, YT,Wang, CY,Si, TM(2010).Sex differences in use of psychotropic drugs and drug-induced side effects in schizophrenia patients: fi ndings of the Research on Asia Psychotropic Prescription (REAP) studies.Aust N Z J Psychiatry,45,193-8.
44. Xiang, YT,Wang, CY,Si, TM(2011).Clozapine use in schizophrenia: fi ndings of the Research on Asia Psychotropic Prescription (REAP) studies from 2001 to 2009.Aust N Z J Psychiatry,45,968-75.
45. Xiang, YT,Wang, CY,Si, TM(2013).The low frequency of reported sexual dysfunction in Asian patients with schizophrenia (2001-2009): low occurrence or ignored side effect?.Hum Psychopharmacol,26,352-7.
46. Xiang, YT,Wang, CY,Si, TM(2011).Use of anticholinergic drugs in patients with schizophrenia in Asia from 2001 to 2009.Pharmacopsychiatry,44,114-8.
47. Xiang, YT,Wang, CY,Si, TM(2012).Antipsychotic Polypharmacy in Inpatients with Schizophrenia in Asia (2001-2009).Pharmacopsychiatry,45,7-12.
48. Yoshimura, R,Okamoto, T,Nakamura, J(2006).Prescription pattern of antipsychotic drugs for schizophrenic inpatients in Japan.Psychiatry Clin Neurisci,60,778-9.
49. Zou, YZ,Cui, JF,Han, B(2008).Chinese psychiatrists views on global features of CCMD-III, ICD-10 and DSM-IV.Asian J Psychiatry,1,56-9.

1. Naotaka Shinfuku(2023)。What i have Learned from French Psychiatry。臺灣精神醫學，37(2)，61-69。
2. Takeda, Masatoshi(2014).Hasegawa Dementia Scales: What's in a Name?.台灣精神醫學,28(3),133-135.