Article: An epidemiological study of concomitant use of Chinese medicine and antipsychotics in schizophrenic patients: Implication for herb-drug interaction
| Title | An epidemiological study of concomitant use of Chinese medicine and antipsychotics in schizophrenic patients: Implication for herb-drug interaction | ||||||
|---|---|---|---|---|---|---|---|
| Authors | Zhang, ZJ1 Tan, QR1 Tong, Y1 Wang, XY1 Wang, HH1 Ho, LM1 Wong, HK1 Feng, YB1 di Wang1 Ng, R1 McAlonan, GM1 Wang, CY1 Wong, VT1 | ||||||
| Issue Date | 2011 | ||||||
| Publisher | Public Library of Science. The Journal's web site is located at http://www.plosone.org/home.action | ||||||
| Citation | Plos One, 2011, v. 6 n. 2 [How to Cite?] DOI: http://dx.doi.org/10.1371/journal.pone.0017239 | ||||||
| Abstract | Background: Herb-drug interactions are an important issue in drug safety and clinical practice. The aim of this epidemiological study was to characterize associations of clinical outcomes with concomitant herbal and antipsychotic use in patients with schizophrenia. Methods and Findings: In this retrospective, cross-sectional study, 1795 patients with schizophrenia who were randomly selected from 17 psychiatric hospitals in China were interviewed face-to-face using a structured questionnaire. Association analyses were conducted to examine correlates between Chinese medicine (CM) use and demographic, clinical variables, antipsychotic medication mode, and clinical outcomes. The prevalence of concomitant CM and antipsychotic treatment was 36.4% [95% confidence interval (95% CI) 34.2%-38.6%]. Patients using concomitant CM had a significantly greater chance of improved outcomes than non-CM use (61.1% vs. 34.3%, OR = 3.44, 95% CI 2.80-4.24). However, a small but significant number of patients treated concomitantly with CM had a greater risk of developing worse outcomes (7.2% vs. 4.4%, OR = 2.06, 95% CI 2.06-4.83). Significant predictors for concomitant CM treatment-associated outcomes were residence in urban areas, paranoid psychosis, and exceeding 3 months of CM use. Herbal medicine regimens containing Radix Bupleuri, Fructus Gardenia, Fructus Schisandrae, Radix Rehmanniae, Akebia Caulis, and Semen Plantaginis in concomitant use with quetiapine, clozapine, and olanzepine were associated with nearly 60% of the risk of adverse outcomes. Conclusions: Concomitant herbal and antipsychotic treatment could produce either beneficial or adverse clinical effects in schizophrenic population. Potential herb-drug pharmacokinetic interactions need to be further evaluated. © 2011 Zhang et al. | ||||||
| ISSN | 1932-6203 2011 Impact Factor: 4.092 2011 SCImago Journal Rankings: 0.519 | ||||||
| DOI | http://dx.doi.org/10.1371/journal.pone.0017239 | ||||||
| ISI Accession Number ID | WOS:000287392700064
Funding Information: Funding: This study was supported by the intramural research fund of the University of Hong Kong and Hospital Authority of Hong Kong. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. | ||||||
| PubMed Central ID | PMC3040227 | ||||||
| References | References in Scopus |
| dc.contributor.author | Zhang, ZJ | ||||||
|---|---|---|---|---|---|---|---|
| dc.contributor.author | Tan, QR | ||||||
| dc.contributor.author | Tong, Y | ||||||
| dc.contributor.author | Wang, XY | ||||||
| dc.contributor.author | Wang, HH | ||||||
| dc.contributor.author | Ho, LM | ||||||
| dc.contributor.author | Wong, HK | ||||||
| dc.contributor.author | Feng, YB | ||||||
| dc.contributor.author | di Wang | ||||||
| dc.contributor.author | Ng, R | ||||||
| dc.contributor.author | McAlonan, GM | ||||||
| dc.contributor.author | Wang, CY | ||||||
| dc.contributor.author | Wong, VT | ||||||
| dc.date.accessioned | 2011-07-27T01:34:49Z | ||||||
| dc.date.available | 2011-07-27T01:34:49Z | ||||||
| dc.date.issued | 2011 | ||||||
| dc.description.abstract | Background: Herb-drug interactions are an important issue in drug safety and clinical practice. The aim of this epidemiological study was to characterize associations of clinical outcomes with concomitant herbal and antipsychotic use in patients with schizophrenia. Methods and Findings: In this retrospective, cross-sectional study, 1795 patients with schizophrenia who were randomly selected from 17 psychiatric hospitals in China were interviewed face-to-face using a structured questionnaire. Association analyses were conducted to examine correlates between Chinese medicine (CM) use and demographic, clinical variables, antipsychotic medication mode, and clinical outcomes. The prevalence of concomitant CM and antipsychotic treatment was 36.4% [95% confidence interval (95% CI) 34.2%-38.6%]. Patients using concomitant CM had a significantly greater chance of improved outcomes than non-CM use (61.1% vs. 34.3%, OR = 3.44, 95% CI 2.80-4.24). However, a small but significant number of patients treated concomitantly with CM had a greater risk of developing worse outcomes (7.2% vs. 4.4%, OR = 2.06, 95% CI 2.06-4.83). Significant predictors for concomitant CM treatment-associated outcomes were residence in urban areas, paranoid psychosis, and exceeding 3 months of CM use. Herbal medicine regimens containing Radix Bupleuri, Fructus Gardenia, Fructus Schisandrae, Radix Rehmanniae, Akebia Caulis, and Semen Plantaginis in concomitant use with quetiapine, clozapine, and olanzepine were associated with nearly 60% of the risk of adverse outcomes. Conclusions: Concomitant herbal and antipsychotic treatment could produce either beneficial or adverse clinical effects in schizophrenic population. Potential herb-drug pharmacokinetic interactions need to be further evaluated. © 2011 Zhang et al. | ||||||
| dc.description.nature | published_or_final_version | ||||||
| dc.identifier.citation | Plos One, 2011, v. 6 n. 2 [How to Cite?] DOI: http://dx.doi.org/10.1371/journal.pone.0017239 | ||||||
| dc.identifier.doi | http://dx.doi.org/10.1371/journal.pone.0017239 | ||||||
| dc.identifier.epage | e17239 | ||||||
| dc.identifier.hkuros | 187263 | ||||||
| dc.identifier.isi | WOS:000287392700064
Funding Information: Funding: This study was supported by the intramural research fund of the University of Hong Kong and Hospital Authority of Hong Kong. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. | ||||||
| dc.identifier.issn | 1932-6203 2011 Impact Factor: 4.092 2011 SCImago Journal Rankings: 0.519 | ||||||
| dc.identifier.issue | 2 | ||||||
| dc.identifier.pmcid | PMC3040227 | ||||||
| dc.identifier.pmid | 21359185 | ||||||
| dc.identifier.scopus | eid_2-s2.0-79951939709 | ||||||
| dc.identifier.spage | e17239 | ||||||
| dc.identifier.uri | http://hdl.handle.net/10722/135408 | ||||||
| dc.identifier.volume | 6 | ||||||
| dc.language | eng | ||||||
| dc.publisher | Public Library of Science. The Journal's web site is located at http://www.plosone.org/home.action | ||||||
| dc.publisher.place | United States | ||||||
| dc.relation.ispartof | PLoS ONE | ||||||
| dc.relation.references | References in Scopus | ||||||
| dc.rights | Creative Commons: Attribution 3.0 Hong Kong License | ||||||
| dc.subject.mesh | Antipsychotic Agents - administration and dosage - therapeutic use | ||||||
| dc.subject.mesh | Drugs, Chinese Herbal - therapeutic use | ||||||
| dc.subject.mesh | Herb-Drug Interactions - physiology | ||||||
| dc.subject.mesh | Medicine, Chinese Traditional - adverse effects - utilization | ||||||
| dc.subject.mesh | Schizophrenia - drug therapy - epidemiology | ||||||
| dc.title | An epidemiological study of concomitant use of Chinese medicine and antipsychotics in schizophrenic patients: Implication for herb-drug interaction | ||||||
| dc.type | Article |
Author Affiliations
- The University of Hong Kong