More than Half of Patients with Schizophrenia Are Receiving Polypharmacy and Co-Prescription of Anxiolytics in Pakistan —Findings from Research on Asian Prescription Pattern in 2016

Objective: Little is known about the prescription pattern of psychotropic drugs for patients with schizophrenia in Pakistan. The purpose of this study was to evaluate the characteristic features of psychotropic drug prescriptions for patients with schizophrenia in Pakistan. Methods: Three centers in Pakistan participated in a large scale collaborative study known as Research on Asian Prescription Pattern (REAP). The 2016 REAP survey included centers from 15 countries in Asia and used a unified research protocol. The design of the study was quantitative and of descriptive epidemiology. Analysis was made on the data collected from three centers i.e., Lahore, Karachi and Islamabad. The data collected in Pakistan were compared with those from other Asian countries. The details of REAP were presented on the homepage of REAP (http://www.REAP.Asia). Results: From Pakistan, 298 patients were included. Patients with schizophrenia in Pakistan received higher rate of antipsychotic polypharmacy and a higher rate of co-prescription of mood stabilizers and anxiolytics when compared with participants from other South Asian countries (India and Bangladesh). Conclusion: The main findings of the study were that a majority of the patients were prescribed antipsychotic polypharmacy drugs in Pakistan. Insufficient training on the use of psychotropic drugs and a lack of treatment guideline are considered to be the major contributing factors. Further education and training on the proper use of psychotropic drugs are recommended to psychiatrists in Pakistan. The guidelines on pharmacotherapy for patients with schizophrenia should also be developed and promoted in Pakistan.

Effect of Chinese Herbal Medicine Jinlida Granule in Treatment of Patients with Impaired Glucose Tolerance

Background：Diabetes mellitus （DM） remains a major health problem worldwide.Several clinical trials have shown the superiority of the Traditional Chinese Medicine in delaying or reversing the development and progression of DM.This study aimed to evaluate the efficacy of Jinlida （JLD） granule,a Chinese herbal recipe,in the treatment of impaired glucose tolerance （IGT） and its effect on the prevention of DM.Methods：Sixty-five IGT patients were randomized to receive one bag of JLD granules three times daily （JLD group,n =34） or no drug intervention （control group,n =31） for 12 weeks.Oral glucose tolerance test,glycated hemoglobin A1c （HbA1c）,body mass index,blood lipids levels,fasting insulin,and insulin resistance calculated using homeostatic model assessment （HOMA-IR） of all the patients were observed and compared before and after the treatment.Results：Sixty-one participants completed the trial （32 in JLD group and 29 in the control group）.There were statistically significant decreases in HbA1c （P 〈 0.001）,2-h plasma glucose （P 〈 0.001）,and HOMA-IR （P =0.029） in JLD group compared with the control group after 12 weeks of treatment.After 12 weeks of treatment,two （6.9%） patients returned to normal blood glucose,and five （17.2%） patients turned into DM in control group,while in the JLD group,14 （43.8%） returned to normal blood glucose and 2 （6.2%） turned into DM.There was a significant difference in the number of subjects who had normal glucose at the end of the study between two groups （P =0.001）.Conclusions：JLD granule effectively improved glucose control,increased the conversion of IGT to normal glucose,and improved the insulin resistance in patients with IGT.This Chinese herbal medicine may have a clinical value for IGT.