Evolving patterns of antipsychotic use and polypharmacy for schizophrenia in Hong Kong: a 21-year longitudinal study.
Antipsychotic polypharmacy in schizophrenia rose to 28% of patients by 2024.
Evolving patterns of antipsychotic use and polypharmacy for schizophrenia in Hong Kong: a 21-year longitudinal study.
Antipsychotics are the cornerstone of schizophrenia management, with antipsychotic polypharmacy commonly observed.
This study aims to evaluate the trends of antipsychotic use and polypharmacy among individuals with schizophrenia in Hong Kong.
This retrospective study used territory-wide electronic health records to identify all individuals aged ≥18 years diagnosed with schizophrenia in Hong Kong (2004-2024).
polypharmacy climbed after a decade of decline, now nearly 1 in 4 patients
The overall use of antipsychotics remained stable, with a slight decrease during the study period (average annual percentage change [AAPC] -0.40 [95% CI, -0.42 to -0.38]), though individual agents shifted substantially.
In 2024, olanzapine emerged as the most prevalent antipsychotic (20.6%), while clozapine utilisation grew but remained relatively limited (7.5%).
Use of long-acting injectable antipsychotics (long-acting injectable antipsychotics) declined (AAPC = -0.92 [-1.07 to -0.77]), except SGA-long-acting injectable antipsychotics, which rose, primarily driven by long-acting injectable antipsychotics-paliperidone and long-acting injectable antipsychotics-aripiprazole.
Over the last two decades, overall antipsychotic use in schizophrenia remained stable in Hong Kong, though patterns shifted between agents.
Antipsychotic polypharmacy became more prevalent, emphasising the need for further research on their safety and effectiveness.