- Email: [email protected]
P.3.c.014 Longitudinal changes of metabolic syndrome in patients with schizophrenia and bipolar disorder
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P.3.c. Psychotic disorders and antipsychotics − Antipsychotics (clinical)
antidepressant, SSRI, risperidone therapy. The patient responded to a medication currently indicated only for psychosis in schizophrenia and acute mania in bipolar disorder. Conclusion: Burning mouth syndrome (BMS) is a disorder characterized by a burning sensation of the oral cavity in the absence of local or systemic abnormalities. In the literature a variety of terms are used to describe similar symptoms, such as glossodynia, glossopyrosis, stomatodynia and oral dysestesia. Depression, anxiety disorder, hypochondriasis and conversion disorder may be considered among the psychiatric disorders responsible for this phenomenon. BMS predominantly affects women in the fourth and fifth decades of life, with an overall female–male ratio of 7:1. A variety of causes have been proposed for BMS including oral mucosa disease, menopause, medication and psychosomatic disorders. There is still no single effective treatment regimen for BMS. In this article, we report our experience with quetiapine as a beneficial therpy. This is the first reported case treated with quetiapine of the symptoms of glossodynia (burning mouth syndrome). References [1] Pinto A, Sollecito TP, DeRossi SS (2003) Burning mouth syndrome. NY States Dental Journal. 69(3): 18−25. [2] White TL, Kent PF, Kurtz DB, Emko P (2004) Effectiveness of Gabapentin for treatment of burning mouth syndrome. Arc Otolarin Head and Neck Surgery 130(6): 786–789. [3] Gick CL, Mirowski GW, Kennedy JS, Bymaster FP (2004). Treatment of glossodynia with olnzapine. J Am Acad Dermatol, 51(3): 463–465.
P.3.c.013 Examination of switching to aripiprazole and change of metabolic syndrome scale in overweight schizophrenia: 20 weeks prospective study J. Kim1 ° , H. Kim2 1 Maryknoll General Hospital, Department of Psychiatry, Busan, South-Korea; 2 Go-Sin Hospital Go-Sin University, Department of Psychiatry, Busan, South-Korea Introduction: Atypical antipsychotics that are widely used these days and have an effect on positive symptom as well as negative symptom are the first choice to treat schizophrenia. However, Studies have reported atypical antipsychotics such as olanzapine or clozapine lead to metabolic syndrome and shorten their lives to the general public by 20%. Aripiprazole is one of the recent developed atypical antipsychotics and is effective for both acute and chronic phase treatment. In addition, aripiprazole minimizes side effects and metabolic disorder. Aripiprazole has a unique pharmacological profile that includes partial agonism at D2 receptors, antagonism at 5-HT2 receptors, and partial agonism at 5-HT1A receptors. It means aripiprazole does not induce hypodopaminergia and clinically effective in stabilizing dopamine system. Method: Stable schizophrenia and schizoaffective disorder patients who had been treated with atypical antipsychotics in five psychiatric hospital in Busan downtown area enrolled in 20weeks prospective switch study. Among the patients with BMI of 25 or more, who keep complaining to excessive weight gain, if they want to switch previous drug to replace drug treatment, they were switched to aripiprazole regardless of previous atypical antipsychotics. This study assessed change of related scales of metabolic disorder: serume prolactine level, BMI, WT, fasting glucose, blood pressure, waist circumference, TG and HDL-cholesterol.
Aripiprazole of tolerability and safety were assessed with the Clinical Global Impression scale (CGI), the Simpson–Angus Scale (SAS), the Barnes Akathisia Rating Scale (BARS), and the Abnormal Involuntary Movement Scale (AIMS). When switching existing atypical antipsychotics to aripiprazole, atypical antipsychotics 10 mg and aripiprazole 10 mg were administered in combination for first 4 weeks. If safety dose not seem to be problem, atypical antipsychotics were gradually tapered down. Administration of atypical antipsychotics was stopped and aripiprazole was used within the range of 10 mg to 30 mg/day a 4 to 8-week period. Finishing observation for total 20-weeks, comparative evaluation was started. Results: The patients who consent to a study object and met the Diagnostic criterion and BMI 25 are 15 patients. Study was completed by 11 patients (73%). Atypical antipsychotics agents that patients had taken when they participated in this study were risperidone (6 patients), olanzapine (4 patients), Seroquel (4 patients), Solian and Invega (each 1 patient). At endpoint, the mean dose of aripiprazole was 19.33 mg/day. Mean BMI were decreased by 2.07 (t = 4.930, p < 0.001), the mean change in body weight was 5.19 kg from baseline (t = 1.930, p < 0.001). Mean body waist 2.1 cm, TG 21.23 mg/dL, total cholesterol 15.66 mg/dL, LDH-cholesterol 11.8 mg and Prolactin 55.02 ng/dl were decreased, but not significant statistically. However, only fast blood glucose was increased by 5.09 mg/dL. Pulse, CBC, electrolyte etc. were no difference. Also CGI-S to see change of clinical state and SAS, AIMS, BARS to measure adverse events were no change. Conclusion: After switching to aripiprazole that is unique atypical antipsychotic, stabilized schizophrenia patients with atypical antipsychotics who were BMI 25 and have had negative bodyfigure with low quality of life had no difference in clinical safety, tolerability. However, compared with other atypical antipsychotics, metabolic syndrome (BMI, weight gain, waist, total cholesterol TG, prolactin level etc.) were significantly decreased with aripiprazole. References [1] T. Scott Stroup, Joseph P. MeEvoy, Kimberly D. Hamer et al. A randomized trial examing the effectiveness of switching from Olanzapine, Quetiapine, or Risperidone to Aripiprazole to reduce metabolic risk: Comparison of Antipsychotics for Metabolic Problems (CAMP). Am J Psychiatry 168: 9, September 2011: 947–956. [2] JH Lee, JO Song, SJ Lee, SW Jung, BH Koo, KH Lee. Clinical & metabolic benefits in patients with schizophrenia switched from Risperidone to Ziprasidone: a prospective, open-label trial. J Korean Soc Biol Ther Psychiatry Vol 15, 2009: 88−95. [3] WJ Kim, JC Shim, BG Kong, et al. Body weight and metabolic changes in first-episode psychotic patients with antipsychotics use: A retrospective study. J Korean Soc Biol Ther Psychiatry Vol 17, No 2, 2011: 229–238.
P.3.c.014 Longitudinal changes of metabolic syndrome in patients with schizophrenia and bipolar disorder N.Y. Lee1 ° , S.H. Kim2 , Y.M. Ahn2 , U.G. Kang2 , T. Youn1 , I.W. Chung1 , Y.S. Kim1 1 Dongguk University International Hospital, Department of Neuropsychiatry, Goyang-si, SouthKorea; 2 Seoul National University Hospital, Department of Neuropsychiatry, Seoul, South-Korea Although cross-sectional prevalences of metabolic syndrome (MetS) in patients with schizophrenia and bipolar disorder have
P.3.c. Psychotic disorders and antipsychotics − Antipsychotics (clinical) been reported widely and variously, the longitudinal changes of metabolic syndrome in these populations have rarely been reported. Therefore, longitudinal changes of metabolic syndrome in Korean patients with schizophrenia and bipolar disorder were evaluated. The electronic medical record of patients with schizophrenia and bipolar disorder of Seoul National University Hospital from June 2007 to October 2010 was reviewed and patients with repeated data for all MetS subcomponents were recruited. The American Heart Association and the National Heart, Lung and Blood Institute adaptation of National Cholesterol Education Program Adult Treatment Panel III’s (ATP-IIIA) definition of MetS and waist circumference criterion of the Korean Society for the Study of Obesity were used for analysis. In total, 842 patients with schizophrenia and bipolar disorder had baseline data of MetS, and among these populations, 286 patients had repeated data of MetS. A total of 181 patients with schizophrenia and 105 patients with bipolar disorder were analyzed. Significantly more men were in subjects with schizophrenia than those with bipolar disorder. Mean age, duration of illness, duration of treatment were not different between two diagnostic groups. Among the subcomponent of MetS, only fasting glucose levels were higher in subjects with schizophrenia than those with bipolar disorder. The rate of MetS was 30.4% and was significantly higher in subjects with schizophrenia than those with bipolar disorder. The rate of Mets was changed significantly from 30.4% at baseline to 37.1% at follow-up measurements (p = 0.022). The rate of increased fasting glucose levels, waist circumferences, and elevated blood pressure were changed significantly during followup (p = 0.001, 0.002 and 0.018 respectively). Among patients without metabolic syndrome at baseline (n = 199), 44 patients (22.1%) had newly developed metabolic syndrome at followup measurement. Among patients with metabolic syndrome at baseline (n = 87), 25 patients (28.7%) no longer had metabolic syndrome anymore at follow-up measurement. In patients with schizophrenia, the mean interval of measurements was 12 months and rate of MetS changed from 33.7% to 45.1%. The incidence of MetS was 30% and the reversal rate of that was 26.2%. In patients with bipolar disorder, the mean interval of measurement was 18.9 months and the rate of MetS changed from 24.8% to 23.8% without statistical significance. All subcomponents did not change significantly. The incidence of MetS was 10% and the reversal rate of that was 34.6%. The dynamic change of MetS in patients with schizophrenia was demonstrated, and a considerable number of patients developed or reversed the MetS in about one year. In patients with bipolar disorder with maintenance treatment, the rate of MetS did not change after 18 months. However, a considerable number of patients had newly developed and resolved MetS during the treatment. Therefore, careful evaluation of MetS is needed in the treatment of schizophrenia and bipolar disorder. References [1] Schorr, S.G., Slooff, C.J., Bruggeman. R., Taxis, K., 2009. The incidence of metabolic syndrome and its reversal in a cohort of schizophrenic patients followed for one year. Journal of psychiatric research 43, 1106–1111. [2] Srisurapanont, M., Likhitsathian, S., Boonyanaruthee, V., Charnsilp, C., Jarusuraisin, N., 2007. Metabolic syndrome in Thai schizophrenic patients: a naturalistic one-year follow-up study. BMC psychiatry 7, 14. [3] Meyer, J.M., Davis, V.G., Goff, D.C., McEvoy, J.P., Nasrallah, H.A., Davis, S.M., et al., 2008. Change in metabolic syndrome parameters with antipsychotic treatment in the CATIE Schizophrenia Trial: prospective data from phase 1. Schizophrenia research 101, 273−86.
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P.3.c.015 Patterns of antipsychotics prescription for patients with first-episode schizophrenia in Korea: a comparison of 2005 and 2010 D.Y. Roh1 , C.H. Kim1 ° , J.G. Chang1 , S.K. Ann1 , H.S. Cho1 Mental Health Hospital Yonsei University College of Medicine, Dept. of Psychiatry, Gwangju-si, South-Korea
1 Severance
Purpose: Since the first episode of psychosis is known to be a critical period, there has been an increased focus on first-episode schizophrenia. In the early 2000s, novel classes of antipsychotics have expanded to provide physicians with the tools to treat diverse groups of psychotic patients. Emerging trends towards polypharmacotherapy have been observed over the past decade. The purpose of this study was to quantify and describe recent prescribing trends of antipsychotics use in patients with firstepisode schizophrenia by comparing prescription patterns between the year 2005 and the year 2010. Methods: In this retrospective study, we reviewed the medical records of patients discharged from Severance mental health hospital, a part of the unit of psychiatry, Yonsei University College of Medicine in 2005 and 2010. Comprehensive medication profiles were reviewed for the patients who were diagnosed as having schizophrenia or schizophreniform disorder (DSM-IV-TR, 4th edition) at the time of discharge. Antipsychotic polypharmacy was defined as the receipt of 2 or more chemically distinct antipsychotics concurrently for at least 14 or more days of therapy. The dosing of antipsychotics was calculated by prescribed daily doses (PDD)/defined daily doses (DDD) ratio. Results: A sample of 47 records were reviewed for the year 2005 and 52 were reviewed for the year 2010. There were no differences between the two groups with respect to sex, agemarital status, diagnostic subtype of schizophrenia, total numberof hospitaladmission and duration of illness. Significantly more individuals were treated with mood stabilizers in 2010 than in 2005 (0% vs 17.3%, p < 0.01). In 2005, the four common first-prescribed antipsychotics after being diagnosed schizophrenia were olanzapine (34%), risperidone (34%), aripiprazole (23%) and haloperidol (19.1%). The list of commonly prescribed antipsychotics changed into risperidone (36.5%) quetiapine (23.1%), paliperidone (23.1%) and olanzapine (17.3%) in 2010. There was no significant difference in antipsychotic dose of PDD/DDD ratio (2.06±1.07 vs 2.02±1.16) and prevalence of antipsychotic polypharmacy (34.0% vs 34.6%) between 2005 and 2010. Logistic regression analysis revealed that patients receiving two or more antipsychotic drugs were 8-fold more likely to receive antipsychotic doses higher than a theoretical unit of measurement defined as the assumed average daily dose (OR = 8.68, P < 0.01). Conclusions: There were notable changes in the commonly prescribed antipsychotics list in 2005 and 2010. We noticed more prevalent use of mood stabilizer in 2010. The use of antipsychotic polypharmacy with excessive dosing of antipsychotics did not increase for the patients with first-episode schizophrenia in recent years. Despite the first-episode of psychotic disorder, more than one third of the patients received two or more antipsychotic agents. Further studies should examine the effects of antipsychotic polypharmacy, the optimum antipsychotic dosage and type and level of concomitant medications at early stage of psychosis.
P.3.c. Psychotic disorders and antipsychotics − Antipsychotics (clinical)
antidepressant, SSRI, risperidone therapy. The patient responded to a medication currently indicated only for psychosis in schizophrenia and acute mania in bipolar disorder. Conclusion: Burning mouth syndrome (BMS) is a disorder characterized by a burning sensation of the oral cavity in the absence of local or systemic abnormalities. In the literature a variety of terms are used to describe similar symptoms, such as glossodynia, glossopyrosis, stomatodynia and oral dysestesia. Depression, anxiety disorder, hypochondriasis and conversion disorder may be considered among the psychiatric disorders responsible for this phenomenon. BMS predominantly affects women in the fourth and fifth decades of life, with an overall female–male ratio of 7:1. A variety of causes have been proposed for BMS including oral mucosa disease, menopause, medication and psychosomatic disorders. There is still no single effective treatment regimen for BMS. In this article, we report our experience with quetiapine as a beneficial therpy. This is the first reported case treated with quetiapine of the symptoms of glossodynia (burning mouth syndrome). References [1] Pinto A, Sollecito TP, DeRossi SS (2003) Burning mouth syndrome. NY States Dental Journal. 69(3): 18−25. [2] White TL, Kent PF, Kurtz DB, Emko P (2004) Effectiveness of Gabapentin for treatment of burning mouth syndrome. Arc Otolarin Head and Neck Surgery 130(6): 786–789. [3] Gick CL, Mirowski GW, Kennedy JS, Bymaster FP (2004). Treatment of glossodynia with olnzapine. J Am Acad Dermatol, 51(3): 463–465.
P.3.c.013 Examination of switching to aripiprazole and change of metabolic syndrome scale in overweight schizophrenia: 20 weeks prospective study J. Kim1 ° , H. Kim2 1 Maryknoll General Hospital, Department of Psychiatry, Busan, South-Korea; 2 Go-Sin Hospital Go-Sin University, Department of Psychiatry, Busan, South-Korea Introduction: Atypical antipsychotics that are widely used these days and have an effect on positive symptom as well as negative symptom are the first choice to treat schizophrenia. However, Studies have reported atypical antipsychotics such as olanzapine or clozapine lead to metabolic syndrome and shorten their lives to the general public by 20%. Aripiprazole is one of the recent developed atypical antipsychotics and is effective for both acute and chronic phase treatment. In addition, aripiprazole minimizes side effects and metabolic disorder. Aripiprazole has a unique pharmacological profile that includes partial agonism at D2 receptors, antagonism at 5-HT2 receptors, and partial agonism at 5-HT1A receptors. It means aripiprazole does not induce hypodopaminergia and clinically effective in stabilizing dopamine system. Method: Stable schizophrenia and schizoaffective disorder patients who had been treated with atypical antipsychotics in five psychiatric hospital in Busan downtown area enrolled in 20weeks prospective switch study. Among the patients with BMI of 25 or more, who keep complaining to excessive weight gain, if they want to switch previous drug to replace drug treatment, they were switched to aripiprazole regardless of previous atypical antipsychotics. This study assessed change of related scales of metabolic disorder: serume prolactine level, BMI, WT, fasting glucose, blood pressure, waist circumference, TG and HDL-cholesterol.
Aripiprazole of tolerability and safety were assessed with the Clinical Global Impression scale (CGI), the Simpson–Angus Scale (SAS), the Barnes Akathisia Rating Scale (BARS), and the Abnormal Involuntary Movement Scale (AIMS). When switching existing atypical antipsychotics to aripiprazole, atypical antipsychotics 10 mg and aripiprazole 10 mg were administered in combination for first 4 weeks. If safety dose not seem to be problem, atypical antipsychotics were gradually tapered down. Administration of atypical antipsychotics was stopped and aripiprazole was used within the range of 10 mg to 30 mg/day a 4 to 8-week period. Finishing observation for total 20-weeks, comparative evaluation was started. Results: The patients who consent to a study object and met the Diagnostic criterion and BMI 25 are 15 patients. Study was completed by 11 patients (73%). Atypical antipsychotics agents that patients had taken when they participated in this study were risperidone (6 patients), olanzapine (4 patients), Seroquel (4 patients), Solian and Invega (each 1 patient). At endpoint, the mean dose of aripiprazole was 19.33 mg/day. Mean BMI were decreased by 2.07 (t = 4.930, p < 0.001), the mean change in body weight was 5.19 kg from baseline (t = 1.930, p < 0.001). Mean body waist 2.1 cm, TG 21.23 mg/dL, total cholesterol 15.66 mg/dL, LDH-cholesterol 11.8 mg and Prolactin 55.02 ng/dl were decreased, but not significant statistically. However, only fast blood glucose was increased by 5.09 mg/dL. Pulse, CBC, electrolyte etc. were no difference. Also CGI-S to see change of clinical state and SAS, AIMS, BARS to measure adverse events were no change. Conclusion: After switching to aripiprazole that is unique atypical antipsychotic, stabilized schizophrenia patients with atypical antipsychotics who were BMI 25 and have had negative bodyfigure with low quality of life had no difference in clinical safety, tolerability. However, compared with other atypical antipsychotics, metabolic syndrome (BMI, weight gain, waist, total cholesterol TG, prolactin level etc.) were significantly decreased with aripiprazole. References [1] T. Scott Stroup, Joseph P. MeEvoy, Kimberly D. Hamer et al. A randomized trial examing the effectiveness of switching from Olanzapine, Quetiapine, or Risperidone to Aripiprazole to reduce metabolic risk: Comparison of Antipsychotics for Metabolic Problems (CAMP). Am J Psychiatry 168: 9, September 2011: 947–956. [2] JH Lee, JO Song, SJ Lee, SW Jung, BH Koo, KH Lee. Clinical & metabolic benefits in patients with schizophrenia switched from Risperidone to Ziprasidone: a prospective, open-label trial. J Korean Soc Biol Ther Psychiatry Vol 15, 2009: 88−95. [3] WJ Kim, JC Shim, BG Kong, et al. Body weight and metabolic changes in first-episode psychotic patients with antipsychotics use: A retrospective study. J Korean Soc Biol Ther Psychiatry Vol 17, No 2, 2011: 229–238.
P.3.c.014 Longitudinal changes of metabolic syndrome in patients with schizophrenia and bipolar disorder N.Y. Lee1 ° , S.H. Kim2 , Y.M. Ahn2 , U.G. Kang2 , T. Youn1 , I.W. Chung1 , Y.S. Kim1 1 Dongguk University International Hospital, Department of Neuropsychiatry, Goyang-si, SouthKorea; 2 Seoul National University Hospital, Department of Neuropsychiatry, Seoul, South-Korea Although cross-sectional prevalences of metabolic syndrome (MetS) in patients with schizophrenia and bipolar disorder have
P.3.c. Psychotic disorders and antipsychotics − Antipsychotics (clinical) been reported widely and variously, the longitudinal changes of metabolic syndrome in these populations have rarely been reported. Therefore, longitudinal changes of metabolic syndrome in Korean patients with schizophrenia and bipolar disorder were evaluated. The electronic medical record of patients with schizophrenia and bipolar disorder of Seoul National University Hospital from June 2007 to October 2010 was reviewed and patients with repeated data for all MetS subcomponents were recruited. The American Heart Association and the National Heart, Lung and Blood Institute adaptation of National Cholesterol Education Program Adult Treatment Panel III’s (ATP-IIIA) definition of MetS and waist circumference criterion of the Korean Society for the Study of Obesity were used for analysis. In total, 842 patients with schizophrenia and bipolar disorder had baseline data of MetS, and among these populations, 286 patients had repeated data of MetS. A total of 181 patients with schizophrenia and 105 patients with bipolar disorder were analyzed. Significantly more men were in subjects with schizophrenia than those with bipolar disorder. Mean age, duration of illness, duration of treatment were not different between two diagnostic groups. Among the subcomponent of MetS, only fasting glucose levels were higher in subjects with schizophrenia than those with bipolar disorder. The rate of MetS was 30.4% and was significantly higher in subjects with schizophrenia than those with bipolar disorder. The rate of Mets was changed significantly from 30.4% at baseline to 37.1% at follow-up measurements (p = 0.022). The rate of increased fasting glucose levels, waist circumferences, and elevated blood pressure were changed significantly during followup (p = 0.001, 0.002 and 0.018 respectively). Among patients without metabolic syndrome at baseline (n = 199), 44 patients (22.1%) had newly developed metabolic syndrome at followup measurement. Among patients with metabolic syndrome at baseline (n = 87), 25 patients (28.7%) no longer had metabolic syndrome anymore at follow-up measurement. In patients with schizophrenia, the mean interval of measurements was 12 months and rate of MetS changed from 33.7% to 45.1%. The incidence of MetS was 30% and the reversal rate of that was 26.2%. In patients with bipolar disorder, the mean interval of measurement was 18.9 months and the rate of MetS changed from 24.8% to 23.8% without statistical significance. All subcomponents did not change significantly. The incidence of MetS was 10% and the reversal rate of that was 34.6%. The dynamic change of MetS in patients with schizophrenia was demonstrated, and a considerable number of patients developed or reversed the MetS in about one year. In patients with bipolar disorder with maintenance treatment, the rate of MetS did not change after 18 months. However, a considerable number of patients had newly developed and resolved MetS during the treatment. Therefore, careful evaluation of MetS is needed in the treatment of schizophrenia and bipolar disorder. References [1] Schorr, S.G., Slooff, C.J., Bruggeman. R., Taxis, K., 2009. The incidence of metabolic syndrome and its reversal in a cohort of schizophrenic patients followed for one year. Journal of psychiatric research 43, 1106–1111. [2] Srisurapanont, M., Likhitsathian, S., Boonyanaruthee, V., Charnsilp, C., Jarusuraisin, N., 2007. Metabolic syndrome in Thai schizophrenic patients: a naturalistic one-year follow-up study. BMC psychiatry 7, 14. [3] Meyer, J.M., Davis, V.G., Goff, D.C., McEvoy, J.P., Nasrallah, H.A., Davis, S.M., et al., 2008. Change in metabolic syndrome parameters with antipsychotic treatment in the CATIE Schizophrenia Trial: prospective data from phase 1. Schizophrenia research 101, 273−86.
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P.3.c.015 Patterns of antipsychotics prescription for patients with first-episode schizophrenia in Korea: a comparison of 2005 and 2010 D.Y. Roh1 , C.H. Kim1 ° , J.G. Chang1 , S.K. Ann1 , H.S. Cho1 Mental Health Hospital Yonsei University College of Medicine, Dept. of Psychiatry, Gwangju-si, South-Korea
1 Severance
Purpose: Since the first episode of psychosis is known to be a critical period, there has been an increased focus on first-episode schizophrenia. In the early 2000s, novel classes of antipsychotics have expanded to provide physicians with the tools to treat diverse groups of psychotic patients. Emerging trends towards polypharmacotherapy have been observed over the past decade. The purpose of this study was to quantify and describe recent prescribing trends of antipsychotics use in patients with firstepisode schizophrenia by comparing prescription patterns between the year 2005 and the year 2010. Methods: In this retrospective study, we reviewed the medical records of patients discharged from Severance mental health hospital, a part of the unit of psychiatry, Yonsei University College of Medicine in 2005 and 2010. Comprehensive medication profiles were reviewed for the patients who were diagnosed as having schizophrenia or schizophreniform disorder (DSM-IV-TR, 4th edition) at the time of discharge. Antipsychotic polypharmacy was defined as the receipt of 2 or more chemically distinct antipsychotics concurrently for at least 14 or more days of therapy. The dosing of antipsychotics was calculated by prescribed daily doses (PDD)/defined daily doses (DDD) ratio. Results: A sample of 47 records were reviewed for the year 2005 and 52 were reviewed for the year 2010. There were no differences between the two groups with respect to sex, agemarital status, diagnostic subtype of schizophrenia, total numberof hospitaladmission and duration of illness. Significantly more individuals were treated with mood stabilizers in 2010 than in 2005 (0% vs 17.3%, p < 0.01). In 2005, the four common first-prescribed antipsychotics after being diagnosed schizophrenia were olanzapine (34%), risperidone (34%), aripiprazole (23%) and haloperidol (19.1%). The list of commonly prescribed antipsychotics changed into risperidone (36.5%) quetiapine (23.1%), paliperidone (23.1%) and olanzapine (17.3%) in 2010. There was no significant difference in antipsychotic dose of PDD/DDD ratio (2.06±1.07 vs 2.02±1.16) and prevalence of antipsychotic polypharmacy (34.0% vs 34.6%) between 2005 and 2010. Logistic regression analysis revealed that patients receiving two or more antipsychotic drugs were 8-fold more likely to receive antipsychotic doses higher than a theoretical unit of measurement defined as the assumed average daily dose (OR = 8.68, P < 0.01). Conclusions: There were notable changes in the commonly prescribed antipsychotics list in 2005 and 2010. We noticed more prevalent use of mood stabilizer in 2010. The use of antipsychotic polypharmacy with excessive dosing of antipsychotics did not increase for the patients with first-episode schizophrenia in recent years. Despite the first-episode of psychotic disorder, more than one third of the patients received two or more antipsychotic agents. Further studies should examine the effects of antipsychotic polypharmacy, the optimum antipsychotic dosage and type and level of concomitant medications at early stage of psychosis.