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Article: An epidemiological study of concomitant use of Chinese medicine and antipsychotics in schizophrenic patients: Implication for herb-drug interaction

TitleAn epidemiological study of concomitant use of Chinese medicine and antipsychotics in schizophrenic patients: Implication for herb-drug interaction
Authors
Issue Date2011
PublisherPublic 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?
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.
Persistent Identifierhttp://hdl.handle.net/10722/135408
ISSN
2013 Impact Factor: 3.534
2013 SCImago Journal Rankings: 1.724
PubMed Central ID
ISI Accession Number ID
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.

References

 

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
DC FieldValueLanguage
dc.contributor.authorZhang, ZJen_HK
dc.contributor.authorTan, QRen_HK
dc.contributor.authorTong, Yen_HK
dc.contributor.authorWang, XYen_HK
dc.contributor.authorWang, HHen_HK
dc.contributor.authorHo, LMen_HK
dc.contributor.authorWong, HKen_HK
dc.contributor.authorFeng, YBen_HK
dc.contributor.authordi Wangen_HK
dc.contributor.authorNg, Ren_HK
dc.contributor.authorMcAlonan, GMen_HK
dc.contributor.authorWang, CYen_HK
dc.contributor.authorWong, VTen_HK
dc.date.accessioned2011-07-27T01:34:49Z-
dc.date.available2011-07-27T01:34:49Z-
dc.date.issued2011en_HK
dc.identifier.citationPlos One, 2011, v. 6 n. 2en_HK
dc.identifier.issn1932-6203en_HK
dc.identifier.urihttp://hdl.handle.net/10722/135408-
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.en_HK
dc.languageengen_US
dc.publisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.actionen_HK
dc.relation.ispartofPLoS ONEen_HK
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 interactionen_HK
dc.typeArticleen_HK
dc.identifier.emailZhang, ZJ: zhangzj@hkucc.hku.hken_HK
dc.identifier.emailTong, Y: tongyao@hku.hken_HK
dc.identifier.emailHo, LM: lmho@hkucc.hku.hken_HK
dc.identifier.emailFeng, YB: yfeng@hku.hken_HK
dc.identifier.emailMcAlonan, GM: mcalonan@hkucc.hku.hken_HK
dc.identifier.authorityZhang, ZJ=rp01297en_HK
dc.identifier.authorityTong, Y=rp00509en_HK
dc.identifier.authorityHo, LM=rp00360en_HK
dc.identifier.authorityFeng, YB=rp00466en_HK
dc.identifier.authorityMcAlonan, GM=rp00475en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1371/journal.pone.0017239en_HK
dc.identifier.pmid21359185-
dc.identifier.pmcidPMC3040227-
dc.identifier.scopuseid_2-s2.0-79951939709en_HK
dc.identifier.hkuros187263en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79951939709&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume6en_HK
dc.identifier.issue2en_HK
dc.identifier.spagee17239en_US
dc.identifier.epagee17239en_US
dc.identifier.eissn1932-6203-
dc.identifier.isiWOS:000287392700064-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridZhang, ZJ=8061473900en_HK
dc.identifier.scopusauthoridTan, QR=7102120177en_HK
dc.identifier.scopusauthoridTong, Y=9045384000en_HK
dc.identifier.scopusauthoridWang, XY=35738090600en_HK
dc.identifier.scopusauthoridWang, HH=10144885500en_HK
dc.identifier.scopusauthoridHo, LM=7402955625en_HK
dc.identifier.scopusauthoridWong, HK=36920239700en_HK
dc.identifier.scopusauthoridFeng, YB=24467969600en_HK
dc.identifier.scopusauthoriddi Wang=39863702200en_HK
dc.identifier.scopusauthoridNg, R=7102153803en_HK
dc.identifier.scopusauthoridMcAlonan, GM=6603123011en_HK
dc.identifier.scopusauthoridWang, CY=35345843000en_HK
dc.identifier.scopusauthoridWong, VT=16176799600en_HK

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