Table 1.
Characteristic | ≥ 10% dose reduction cohorts | ≥ 30% dose reduction cohorts | ||
---|---|---|---|---|
Dose reduction [n = 276,030] | Stable dose [n = 276,030] | Dose reduction [n = 211,575] | Stable dose [n = 211,575] | |
Age, years [mean (SD)]a | 56.6 (15.6) | 56.6 (15.6) | 57.0 (15.7) | 56.9 (15.7) |
Schizophrenia duration, months [mean (SD)]a | 32.7 (21.3) | 23.5 (21.5) | 32.4 (21.3) | 23.5 (21.6) |
Sex, male | 137,334 (49.8) | 137,334 (49.8) | 103,817 (49.1) | 103,817 (49.1) |
Duration of follow-up, months [mean (SD)]a | 5.0 (6.9) | 9.1 (8.7) | 4.5 (6.6) | 9.1 (8.6) |
Index drug class | ||||
Typical antipsychotic | 33,942 (12.3) | 33,942 (12.3) | 26,548 (12.5) | 26,548 (12.5) |
Atypical antipsychotic | 242,088 (87.7) | 242,088 (87.7) | 185,027 (87.5) | 185,027 (87.5) |
Index year | ||||
2011 | 18,132 (6.6) | 18,132 (6.6) | 13,603 (6.4) | 13,603 (6.4) |
2012 | 42,148 (15.3) | 42,148 (15.3) | 32,129 (15.2) | 32,129 (15.2) |
2013 | 42,737 (15.5) | 42,737 (15.5) | 32,858 (15.5) | 32,858 (15.5) |
2014 | 42,806 (15.5) | 42,806 (15.5) | 32,926 (15.6) | 32,926 (15.6) |
2015 | 42,145 (15.3) | 42,145 (15.3) | 32,282 (15.3) | 32,282 (15.3) |
2016 | 43,210 (15.7) | 43,210 (15.7) | 33,174 (15.7) | 33,174 (15.7) |
2017 | 44,852 (16.2) | 44,852 (16.2) | 34,603 (16.4) | 34,603 (16.4) |
Comorbidity profile | ||||
Substance-related and addictive disordersa | 72,508 (26.3) | 84,623 (30.7) | 56,789 (26.8) | 64,341 (30.4) |
Anxiety disordersa | 75,593 (27.4) | 86,252 (31.2) | 60,034 (28.4) | 66,460 (31.4) |
Bipolar disordersa | 84,331 (30.6) | 90,413 (32.8) | 66,073 (31.2) | 68,996 (32.6) |
Depressive disordersa | 98,003 (35.5) | 111,274 (40.3) | 77,950 (36.8) | 85,710 (40.5) |
Personality disordersa | 13,426 (4.9) | 14,441 (5.2) | 10,410 (4.9) | 11,046 (5.2) |
Schizophrenia-spectrum disorders (excluding schizophrenia)a | 50,792 (18.4) | 60,633 (22.0) | 40,311 (19.1) | 46,762 (22.1) |
Sleep–wake disordersa | 43,368 (15.7) | 48,852 (17.7) | 34,212 (16.2) | 37,552 (17.7) |
TDa | 2778 (1.0) | 2488 (0.9) | 2094 (1.0) | 1929 (0.9) |
Trauma- and stressor-related disordersa | 20,009 (7.2) | 23,280 (8.4) | 15,930 (7.5) | 17,862 (8.4) |
CCI score [mean (SD)] | 1.3 (1.8) | 1.4 (1.9) | 1.4 (1.9) | 1.4 (1.9) |
AIDS/HIVa | 2812 (1.0) | 3638 (1.3) | 2255 (1.1) | 2760 (1.3) |
Cancera | 11,017 (4.0) | 12,206 (4.4) | 8601 (4.1) | 9552 (4.5) |
Cerebrovascular diseasea | 28,628 (10.4) | 30,384 (11.0) | 23,156 (10.9) | 23,711 (11.2) |
Congestive heart failurea | 29,494 (10.7) | 32,278 (11.7) | 23,924 (11.3) | 25,160 (11.9) |
Chronic pulmonary diseasea | 76,219 (27.6) | 80,209 (29.1) | 59,860 (28.3) | 61,771 (29.2) |
Dementiaa | 39,795 (14.4) | 37,633 (13.6) | 32,150 (15.2) | 29,926 (14.1) |
Diabetes with chronic complicationsa | 30,132 (10.9) | 29,615 (10.7) | 23,690 (11.2) | 22,794 (10.8) |
Diabetes without chronic complicationsa | 63,767 (23.1) | 61,593 (22.3) | 49,081 (23.2) | 47,381 (22.4) |
Hemiplegia or paraplegia | 6626 (2.4) | 6705 (2.4) | 5286 (2.5) | 5126 (2.4) |
Mild liver diseasea | 14,329 (5.2) | 15,950 (5.8) | 11,309 (5.3) | 12,093 (5.7) |
Metastatic solid tumora | 1851 (0.7) | 2723 (1.0) | 1480 (0.7) | 2081 (1.0) |
Myocardial infarctiona | 7371 (2.7) | 9810 (3.6) | 6030 (2.9) | 7584 (3.6) |
Moderate or severe liver diseasea | 1808 (0.7) | 2081 (0.8) | 1490 (0.7) | 1611 (0.8) |
Peptic ulcer diseasea | 3706 (1.3) | 4327 (1.6) | 2984 (1.4) | 3321 (1.6) |
Peripheral vascular diseasea | 46,715 (16.9) | 41,277 (15.0) | 36,961 (17.5) | 32,174 (15.2) |
Renal diseasea | 26,030 (9.4) | 27,345 (9.9) | 20,718 (9.8) | 21,285 (10.1) |
Rheumatic diseasea | 5786 (2.1) | 7012 (2.5) | 4611 (2.2) | 5427 (2.6) |
Additional psychiatric medications | ||||
ADHD medicationa | 7476 (2.7) | 8349 (3.0) | 5836 (2.8) | 6304 (3.0) |
Anticholinergica | 62,729 (22.7) | 54,139 (19.6) | 47,200 (22.3) | 41,198 (19.5) |
Antidepressanta | 171,161 (62.0) | 175,336 (63.5) | 132,777 (62.8) | 134,610 (63.6) |
Anxiety medicationa | 73,571 (26.7) | 80,173 (29.0) | 57,518 (27.2) | 61,747 (29.2) |
Mood stabilizera | 121,424 (44.0) | 113,000 (40.9) | 93,582 (44.2) | 86,429 (40.9) |
Sedativea | 27,856 (10.1) | 33,144 (12.0) | 22,219 (10.5) | 25,471 (12.0) |
Data are expressed as n (%) unless otherwise specified
ADHD attention-deficit hyperactivity disorder, AIDS acquired immunodeficiency syndrome, CCI Charlson Comorbidity Index, HIV human immunodeficiency virus, SD standard deviation, TD tardive dyskinesia
ap < 0.05 for dose reductions versus stable doses in both dose reduction cohorts