Analysis of the trends of polypharmacy and high‐dose prescriptions in Japan

INTRODUCTION: After extensive research, this study explored whether high‐dose prescriptions and polypharmacy remain more frequent in Japan than elsewhere. If confirmed, we aimed to identify the factors that contributed to this unique trend. METHODS: The psychotropic drug prescription patterns for patients with schizophrenia in Japan were reviewed. This was based on a large sample collected from surveys of the Research on Asian Psychotropic Prescription Patterns, an international collaborative research project conducted by Asian psychiatrists to monitor prescriptions of psychotropic drugs for people with mental disorders, in 2001, 2004, 2008, and 2016. RESULTS: The 2016 Research on Asian Psychotropic Prescription Patterns survey revealed that Japan continued to demonstrate the highest rate of polypharmacy and the highest dosages of psychotropic prescription drugs for patients with schizophrenia among the 15 countries and areas that participated in the survey. DISCUSSION: The Research on Asian Psychotropic Prescription Patterns surveys demonstrated that science plays a limited role in the decision‐making process for prescriptions of psychotropic medications. Such prescriptions are influenced by a wide range of factors, such as the national mental health policy, prescription‐financing systems, the history of psychiatry in each country, and the prevailing culture. Hospital‐based national mental health policies and mental health financing systems have been the primary obstacles to reducing polypharmacy in Japan.