Length of mechanical restraint following haloperidol injections versus oral atypical antipsychotics for the initial treatment of acute schizophrenia: A propensity-matched analysis from the Japanese diagnosis procedure combination database

• Published in: Psychiatry research Vol. 209; no. 3; pp. 412 - 416
• Main Authors: Nakamura, Mitsuhiro, Yasunaga, Hideo, Haraguchi, Tadashi, Ando, Shuntaro, Sugihara, Toru, Horiguchi, Hiromasa, Ohe, Kazuhiko, Matsuda, Shinya, Fushimi, Kiyohide
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ireland Ltd 30.10.2013; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Age Factors; Aged; Antipsychotic Agents - therapeutic use; Atypical antipsychotics; Biological and medical sciences; Case-Control Studies; Databases, Bibliographic - statistics & numerical data; Female; Haloperidol; Haloperidol - therapeutic use; Humans; Involuntary admission; Japan - epidemiology; Kaplan-Meier Estimate; Male; Medical sciences; Middle Aged; Neuropharmacology; Pharmacology. Drug treatments; Propensity score matching; Psychiatric Status Rating Scales; Psychiatry; Psycholeptics: tranquillizer, neuroleptic; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Psychoses; Retrospective Studies; Schizophrenia; Schizophrenia - diagnosis; Schizophrenia - drug therapy; Schizophrenia - epidemiology; Survival analysis; Treatment Outcome; Young Adult; Japan; Schizophrenia; Propensity score matching; Survival analysis; Atypical antipsychotics; Involuntary admission; Haloperidol; Atypical antipsychotic; Neuroleptic; Psychotropic; Dopamine antagonist; Acute; Oral administration; Forced hospitalization; Butyrophenone derivatives; Japanese; Psychosis; D2 Dopamine receptor; Treatment; Length; Database; Restraint; Diagnosis; Comparative study
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2013.02.005

Abstract Differences in effectiveness between haloperidol injection and oral atypical antipsychotics in the acute-phase treatment of schizophrenia are not well examined. We retrospectively investigated whether these treatment options affected the length of mechanical restraint. We used the Japanese Diagnosis Procedure Combination Database to identify schizophrenia patients who were involuntarily hospitalized and receiving mechanical restraint between July and December, 2006–2009. Data included patient demographics, use of antipsychotics, and number of days on which patients underwent mechanical restraint. Propensity score matching was performed to compare the number of days of mechanical restraint between the haloperidol injection group and the oral atypical antipsychotics group. We used survival analysis to examine whether the initial difference in treatment affected the number of days of mechanical restraint. Cox regression was performed to compare the concurrent effects of various factors. Among 1731 eligible patients, 574 were treated with haloperidol injections and 420 with atypical antipsychotics. Matching produced 274 patients in each group. Cox regression analysis showed that the initial therapeutic agents did not significantly affect the number of days of mechanical restraint. The results indicate that atypical antipsychotics were as effective as haloperidol injections in the acute-phase treatment of schizophrenia.