ArticleEuropean archives of psychiatry and clinical neuroscience2025
Age and sex differences in outpatient antipsychotic prescriptions for schizophrenia: a claims data study.
Article in European archives of psychiatry and clinical neuroscience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Influence of Sex and Diagnosis on Clinical Variables and Neurocognitive Performance in Severe Mental Illness. Results From the PsyCourse Study.Acta psychiatrica Scandinavica · 2026Article
- Causal links among gut microbiota, immune-inflammatory and compensatory immune-regulatory systems, and schizophrenia.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- Analysis of drug-drug interactions between psychiatric drugs in spontaneous adverse drug reaction reports from EudraVigilance.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Sex Differences in Psychotropic Drug Exposure and Safety: A Systematic Review Toward Personalized Dosing Strategies.Journal of personalized medicine · 2026Review
- Sex Differences in Schizophrenia Across the Reproductive Lifespan.Current psychiatry reports · 2026Review
- Age and Sex Differences in Adverse Events Associated With Antipsychotics: An Analysis of the FDA Adverse Events Database.International journal of geriatric psychiatry · 2025Article
Corrections and comments
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Authors and funding
8 authors.
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Abstract
Most studies on antipsychotic efficacy and safety, including sex differences, focus on young schizophrenia patients. However, with an aging population, the number of older schizophrenia patients is increasing. This group faces challenges due to varying treatment responses and higher risks of adverse reactions, and guidelines often lack specific recommendations due to insufficient trials. Therefore, we investigated how age and sex influence antipsychotic prescribing practices in schizophrenia using the German Pharmacoepidemiological Research Database (GePaRD). We included patients diagnosed with schizophrenia (ICD-10 code F20.X) who had been prescribed at least one antipsychotic on an outpatient basis in at least two consecutive quarters in 2020, analyzing prescription data for 49,681 patients. Key findings include a notable preference for second-generation antipsychotics (SGAs) across all age groups, especially in younger patients, possibly due to their perceived better tolerability and efficacy. Treatment intensity with SGAs (expressed as the defined daily doses of SGAs per patient in 2020) initially increased with age, peaked among 35- to 44-year-olds, and then decreased, with the lowest treatment intensity in patients aged 65 years and older. The prescription patterns of specific SGAs and first-generation antipsychotics varied across age groups, highlighting the complexity of treatment decisions in schizophrenia management. Sex differences in prescription frequency and treatment intensity were also observed. The basic recommendation of the guideline to consider sex and age when prescribing antipsychotics therefore appears to be followed. Whether this prescribing practice is really optimal for older male and female schizophrenia patients, however, still needs to be proven in clinical trials.
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