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Article: An epidemiological study of concomitant use of Chinese medicine and antipsychotics in schizophrenic patients: Implication for herb-drug interaction
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TitleAn epidemiological study of concomitant use of Chinese medicine and antipsychotics in schizophrenic patients: Implication for herb-drug interaction
 
AuthorsZhang, ZJ2 3
Tan, QR2
Tong, Y3
Wang, XY6
Wang, HH2
Ho, LM3
Wong, HK3
Feng, YB3
di Wang3
Ng, R4
McAlonan, GM3
Wang, CY5
Wong, VT1
 
Issue Date2011
 
PublisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.action
 
CitationPlos One, 2011, v. 6 n. 2 [How to Cite?]
DOI: http://dx.doi.org/10.1371/journal.pone.0017239
 
AbstractBackground: 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.
 
ISSN1932-6203
2013 Impact Factor: 3.534
2013 SCImago Journal Rankings: 1.724
 
DOIhttp://dx.doi.org/10.1371/journal.pone.0017239
 
PubMed Central IDPMC3040227
 
ISI Accession Number IDWOS:000287392700064
Funding AgencyGrant Number
University of Hong Kong
Hospital Authority of Hong Kong
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.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorZhang, ZJ
 
dc.contributor.authorTan, QR
 
dc.contributor.authorTong, Y
 
dc.contributor.authorWang, XY
 
dc.contributor.authorWang, HH
 
dc.contributor.authorHo, LM
 
dc.contributor.authorWong, HK
 
dc.contributor.authorFeng, YB
 
dc.contributor.authordi Wang
 
dc.contributor.authorNg, R
 
dc.contributor.authorMcAlonan, GM
 
dc.contributor.authorWang, CY
 
dc.contributor.authorWong, VT
 
dc.date.accessioned2011-07-27T01:34:49Z
 
dc.date.available2011-07-27T01:34:49Z
 
dc.date.issued2011
 
dc.description.abstractBackground: 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.naturepublished_or_final_version
 
dc.identifier.citationPlos One, 2011, v. 6 n. 2 [How to Cite?]
DOI: http://dx.doi.org/10.1371/journal.pone.0017239
 
dc.identifier.doihttp://dx.doi.org/10.1371/journal.pone.0017239
 
dc.identifier.eissn1932-6203
 
dc.identifier.epagee17239
 
dc.identifier.hkuros187263
 
dc.identifier.isiWOS:000287392700064
Funding AgencyGrant Number
University of Hong Kong
Hospital Authority of Hong Kong
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.issn1932-6203
2013 Impact Factor: 3.534
2013 SCImago Journal Rankings: 1.724
 
dc.identifier.issue2
 
dc.identifier.pmcidPMC3040227
 
dc.identifier.pmid21359185
 
dc.identifier.scopuseid_2-s2.0-79951939709
 
dc.identifier.spagee17239
 
dc.identifier.urihttp://hdl.handle.net/10722/135408
 
dc.identifier.volume6
 
dc.languageeng
 
dc.publisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.action
 
dc.publisher.placeUnited States
 
dc.relation.ispartofPLoS ONE
 
dc.relation.referencesReferences in Scopus
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.subject.meshAntipsychotic Agents - administration and dosage - therapeutic use
 
dc.subject.meshDrugs, Chinese Herbal - therapeutic use
 
dc.subject.meshHerb-Drug Interactions - physiology
 
dc.subject.meshMedicine, Chinese Traditional - adverse effects - utilization
 
dc.subject.meshSchizophrenia - drug therapy - epidemiology
 
dc.titleAn epidemiological study of concomitant use of Chinese medicine and antipsychotics in schizophrenic patients: Implication for herb-drug interaction
 
dc.typeArticle
 
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<contributor.author>Wang, HH</contributor.author>
<contributor.author>Ho, LM</contributor.author>
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<contributor.author>Feng, YB</contributor.author>
<contributor.author>di Wang</contributor.author>
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Author Affiliations
  1. Hong Kong Hospital Authority
  2. Xijing Hospital
  3. The University of Hong Kong
  4. Kowloon Hospital
  5. Beijing An Ding Hospital, Capital Medical University
  6. Hebei Medical University