Neuropsychopharmacology Reports最新文献

{"title":"Correction to \"UK Medical Cannabis Registry: A Clinical Outcomes Analysis for Autism Spectrum Disorder\".","authors":"","doi":"10.1002/npr2.70172","DOIUrl":"10.1002/npr2.70172","url":null,"abstract":"","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"46 3","pages":"e70172"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Libido Following Brivaracetam Initiation: A Case Report of Temporal Lobe Epilepsy.","authors":"Toru Horinouchi, Taiki Matsuyama, Mayusa Mito, Yuichi Nakamura, Takahiro A Kato","doi":"10.1002/npr2.70160","DOIUrl":"10.1002/npr2.70160","url":null,"abstract":"<p><strong>Background: </strong>Sexual dysfunction is a common comorbidity in patients with epilepsy; it correlates with seizure frequency and right temporal lobe epilepsy and affects quality of life (QOL). Despite its clinical significance, sexual dysfunction is often underassessed in clinical practice. Brivaracetam (BRV), an anti-seizure medication (ASM) introduced in recent years, is considered to have few psychiatric side effects, and no association with sexual dysfunction has been reported to date. We report a case of temporal lobe epilepsy in which the patient exhibited increased libido following the initiation of BRV.</p><p><strong>Case presentation: </strong>A woman in her 70s with drug-resistant temporal lobe epilepsy, weekly focal seizures, and mild cognitive impairment was treated with brexpiprazole (BXP) for delusions of theft. BRV (50 mg/day) was initiated due to worsening epileptic seizures. Three weeks later, she developed persistent, intrusive sexual urges accompanied by self-stimulatory behavior (e.g., genital touching). She initially concealed these symptoms due to embarrassment but disclosed them at the follow-up 1 month later. Given the temporal association with BRV initiation, the drug was discontinued, resulting in marked improvement within 2 weeks and subsequent resolution. Throughout the course of treatment, no changes were observed in seizure frequency, cognitive function, or other ASMs.</p><p><strong>Discussion: </strong>Previous reports have described increased libido with levetiracetam, which shares the same mechanism of action with BRV. Genetic factors, such as reduced striatal dopamine receptor density associated with DRD2/ANKK1 polymorphisms may contribute to psychiatric side effects. In this case, BRV-associated modulation of neurotransmission may have interacted with a vulnerable dopaminergic system, as indicated by the need for BXP. Preexisting bilateral hippocampal atrophy may also have provided a structural substrate resembling a pharmacologically induced incomplete Klüver-Bucy syndrome. Clinicians should be aware that patients may hesitate to report such symptoms and should actively monitor for changes in libido after initiating BRV.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"46 3","pages":"e70160"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Treatment-Resistant Schizophrenia: A Nationwide Multicenter Study.","authors":"Yusuke Arai, Toru Horinouchi, Hiroyuki Muraoka, Junya Matsumoto, Kazuhiko Yamamuro, Toshinori Nakamura, Hisashi Yamada, Toshiaki Onitsuka, Yuka Yasuda, Naoki Hashimoto, Kazutaka Ohi, Shinichiro Ochi, Yasushi Kawamata, Keisuke Mori, Hirotaka Yamagata, Takashi Tsuboi, Fumitoshi Kodaka, Jun-Ichi Iga, Shusuke Numata, Ken Inada, Koichiro Watanabe, Hikaru Hori, Norio Yasui-Furukori, Ryota Hashimoto","doi":"10.1002/npr2.70163","DOIUrl":"10.1002/npr2.70163","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia is characterized by positive symptoms, negative symptoms, and cognitive impairment and is primarily treated with antipsychotic medications. However, a subset of patients responds inadequately to treatment and is classified as having treatment-resistant schizophrenia (TRS). The prevalence of TRS among patients with schizophrenia remains insufficiently characterized. This study aimed to determine the prevalence of TRS using nationwide data and standardized diagnostic criteria.</p><p><strong>Methods: </strong>This study included patients with schizophrenia who were discharged between 2016 and 2024 from 205 institutions participating in the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project and authorized to prescribe clozapine. TRS was defined according to standardized diagnostic criteria used in Japan. The prevalence of TRS was calculated among patients who underwent a TRS examination by their treating psychiatrist.</p><p><strong>Results: </strong>Among 18 914 patients, 9870 (52.2%) underwent a TRS examination. Among these 9870 patients, 2819 were classified as having TRS, corresponding to a prevalence of 28.6%. Among the 2819 patients with TRS, 1307 were prescribed clozapine at discharge, corresponding to a clozapine treatment rate of 46.4%.</p><p><strong>Conclusions: </strong>This study had the largest sample size among single-cohort studies investigating the prevalence of TRS. The prevalence of TRS was 28.6% among patients with schizophrenia who underwent a TRS examination and was nearly identical to the pooled prevalence reported in studies at low risk of bias in a previous meta-analysis. These findings may provide important evidence regarding the prevalence of TRS in routine clinical practice.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"46 3","pages":"e70163"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Reported Adverse Events in Psychiatric Outpatients Taking Hypnotics: Higher Real-World Frequencies Than Those Listed in Package Inserts.","authors":"Fumi Akasaka, Kuni Akasaka, Kazutake Okada, Naohito Yamaguchi, Yasuo Haruki, Sotaro Sadahiro","doi":"10.1002/npr2.70162","DOIUrl":"10.1002/npr2.70162","url":null,"abstract":"<p><strong>Introduction: </strong>Benzodiazepines (BZDs) are associated with dependence, tolerance, withdrawal, and various adverse effects, and switching to other drug classes is often recommended. Although non-BZD hypnotics are reported in package inserts to have similar but less frequent adverse events, real-world patients often have complex psychiatric and medical backgrounds, and the actual frequency of subjective adverse events may differ substantially from that reported in package inserts. This study aimed to elucidate subjective symptoms potentially related to psychotropic medications using real-world patient data.</p><p><strong>Methods: </strong>This prospective cohort study included patients at the Akebono Clinic who were taking a single hypnotic agent. A total of 314 patients were analyzed. Insomnia severity was assessed using the Athens Insomnia Scale, and 11 self-reported adverse events were evaluated.</p><p><strong>Results: </strong>The frequency of insomnia was 72% for non-BZDs, 52% for BZDs, and 70% for dual orexin receptor antagonists (DORAs) (significantly lower for BZDs; p = 0.0036). Among the 11 self-reported symptoms, two items (thirst and nightmares) were reported as \"always\" or \"often\" by more than 10% of patients; three items (constipation, head heaviness/headache, and abnormal behavior during sleep) by 5%-10%; and four items (lightheadedness, vertigo, abdominal pain, and tremor) by 3%-5%. There were no differences in adverse-event frequencies among non-BZDs, BZDs, and DORAs. Multivariate analyses showed that adverse events were associated with female sex, age < 60 years, and schizophrenia, depression, and anxiety disorders, but not with hypnotic drug classes.</p><p><strong>Conclusions: </strong>Subjective adverse events in patients taking hypnotics occurred more frequently than those reported in package inserts, indicating a clear discrepancy between controlled trial data and real-world clinical experience. Because adverse events were more strongly associated with patient characteristics-such as psychiatric comorbidities, physical conditions, and concomitant medications-than with hypnotic drug class, routine assessment of subjective symptoms through interviews or questionnaires is essential in clinical practice.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"46 3","pages":"e70162"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13524957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible Association Between Interoception and Alexithymia in Patients With Addiction.","authors":"Yuichi Shimohara, Ariyuki Kagaya, Chika Shimohara, Wiktoria Chciuk, Maro G Machizawa, Shigeto Yamawaki","doi":"10.1002/npr2.70169","DOIUrl":"10.1002/npr2.70169","url":null,"abstract":"<p><p>Interoception has been reported to be associated with several psychiatric disorders, including addiction. Alexithymia refers to difficulties in identifying and describing one's own emotions and has also been linked to addictive disorders. However, the relationship between self-reported interoceptive sensitivity and alexithymia in patients with addiction remains insufficiently understood, particularly when current distress and functional impairment are considered. In this study, we examined the relationship between the Body Perception Questionnaire-Body Awareness very short form Japanese version (BPQBAVSFJ), the Toronto Alexithymia Scale-20 (TAS-20), and the Distress and Impact Thermometer (DIT) in 94 patients with addiction. BPQBAVSFJ was significantly correlated with TAS-20 (Pearson r = 0.405, p < 0.001; Spearman rho = 0.458, p < 0.001). This association remained significant after adjustment for age, sex, distress, and impact (B = 0.271, 95% CI = 0.105-0.438, p = 0.002). Distress showed a weak bivariate association with BPQBAVSFJ, whereas impact did not. In the multivariable model, neither distress nor impact independently predicted BPQBAVSFJ. No significant differences in BPQBAVSFJ were observed among the six addiction subtypes or between substance-related and behavioral addictions after adjustment for age and sex. These findings suggest that self-reported interoceptive sensitivity in patients with addiction may be more closely associated with alexithymia than with current distress or functional impairment.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"46 3","pages":"e70169"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three Adult Cases of ADHD With Comorbid Tic Symptoms Successfully Treated With Guanfacine Monotherapy.","authors":"Koji Tada, Teruo Tada, Takashi Tsuboi, Koichiro Watanabe","doi":"10.1002/npr2.70167","DOIUrl":"10.1002/npr2.70167","url":null,"abstract":"<p><p>Tic disorders typically begin in childhood and often improve by adulthood, but some individuals continue to experience tic symptoms into adult life. Tic disorders frequently co-occur with Attention-deficit/hyperactivity disorder (ADHD), and in such cases α2-adrenergic agonists are recommended as a treatment as they can address both conditions. However, evidence in adults with ADHD and comorbid tic disorders is limited, as most studies have focused on pediatric populations. Here, we present three adult male patients with childhood-onset ADHD and chronic tic symptoms who showed a rapid and significant improvement in tics with low-dose extended-release guanfacine (GXR) monotherapy. These cases suggest that GXR can effectively treat both ADHD and tic symptoms in adults-a finding that has not been well documented in prior adult studies.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"46 3","pages":"e70167"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebrospinal Fluid p75 Neurotrophin Receptor Ectodomain Levels Across Clinically Diagnosed Alzheimer's Disease, Late-Life Depression, and Healthy Aging: A Preliminary Cross-Sectional Study.","authors":"Wataru Omori, Naoto Kajitani, Mami Okada-Tsuchioka, Minoru Takebayashi","doi":"10.1002/npr2.70171","DOIUrl":"10.1002/npr2.70171","url":null,"abstract":"<p><strong>Objective: </strong>The p75 neurotrophin receptor ectodomain (p75NTR-ECD) has been implicated in amyloid-β-related neurotoxicity, but cerebrospinal fluid (CSF) levels in late-life depression (LLD) remain uncertain. We compared clinically diagnosed Alzheimer's disease (AD), LLD, and healthy controls (HC) and reassessed exploratory symptom and cognitive associations.</p><p><strong>Methods: </strong>CSF p75NTR-ECD was measured in 50 participants (HC, n = 19; LLD, n = 19; AD, n = 12). The primary linear model adjusted for age, sex, and body mass index. Exploratory symptom and cognitive models additionally adjusted for diagnostic group; six p values underwent Benjamini-Hochberg false discovery rate (FDR) correction. Plate and below-calibrator sensitivity analyses were performed.</p><p><strong>Results: </strong>CSF p75NTR-ECD was higher in HC than in AD (B = 131.2 pg/mL, 95% CI 42.8-219.6, p = 0.005) and higher in LLD than in AD (B = 154.6 pg/mL, 95% CI 68.9-240.3, p < 0.001); HC and LLD did not differ. No symptom or cognitive association remained significant after diagnostic-group adjustment and FDR correction (all q ≥ 0.117). Plate adjustment did not materially change the primary contrasts. Excluding three concentrations below the lowest calibrator preserved the LLD-AD contrast but attenuated the HC-AD contrast.</p><p><strong>Conclusions: </strong>CSF p75NTR-ECD showed preliminary differences across clinically defined groups. Because the sample was small, the recruitment site was perfectly confounded with AD versus non-AD status, and diagnoses were not uniformly biomarker-confirmed, the findings do not establish causality, clinical diagnostic utility, or added value beyond established AD biomarkers and require independent multisite replication.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"46 3","pages":"e70171"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Japanese Versions of the 4-Item Mystical Experience Questionnaire and 7-Item Challenging Experience Questionnaire.","authors":"Futaba Umemura, Hiroko Kotajima-Murakami, Justin C Strickland, Albert Garcia-Romeu, Matthew W Johnson, Kazutaka Ikeda","doi":"10.1002/npr2.70164","DOIUrl":"10.1002/npr2.70164","url":null,"abstract":"<p><strong>Introduction: </strong>Interest in therapeutic applications of psychedelics has recently resurged. Mystical-type and challenging experiences that are elicited by psychedelics are commonly assessed using the 30-item Mystical Experience Questionnaire (MEQ-30) and the 26-item Challenging Experience Questionnaire (CEQ), respectively. The brief 4-item MEQ (MEQ-4) and 7-item CEQ (CEQ-7) may reduce respondent burden, but Japanese versions have not yet been developed. This study developed Japanese versions of the MEQ-4 and CEQ-7.</p><p><strong>Methods: </strong>In translating the MEQ-4 and CEQ-7, our procedures were informed by the recommendations of the \"Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: Report of the ISPOR Task Force for Translation and Cultural Adaptation.\" Separately, experts in psychedelics reviewed semantic nuances and the naturalness and appropriateness of the Japanese wording. Cognitive debriefing was not conducted because recruiting an appropriate Japanese-speaking sample with psychedelic experience was not feasible.</p><p><strong>Results: </strong>The final, approved back-translated versions of the MEQ-4 and CEQ-7 were developed, and the authorized Japanese versions of the MEQ-4 and CEQ-7 were established.</p><p><strong>Conclusions: </strong>In the present study, Japanese versions of the MEQ-4 and CEQ-7 were developed, enabling more rapid and efficient assessments of mystical and challenging experiences among Japanese speakers. Future studies should evaluate their comprehensibility, interpretability, cultural appropriateness, reliability, and validity in Japanese-speaking samples.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"46 3","pages":"e70164"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Context-Dependent Temporal Changes in Hypnotics Involved in Suicide Attempts.","authors":"Taro Sasaki, Norio Sugawara, Motoharu Furukawa, Hirotaka Iwaki, Shiro Suda, Norio Yasui-Furukori","doi":"10.1002/npr2.70126","DOIUrl":"10.1002/npr2.70126","url":null,"abstract":"<p><strong>Background: </strong>Recent prescribing practices have shifted from benzodiazepines (BZs) toward non-GABAergic hypnotics, including dual orexin receptor antagonists (DORAs) and melatonin receptor agonists (MRAs). We examined whether hypnotics involved in suicide attempts changed over time in a context-dependent manner.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study of consecutive patients presenting with suicide attempts at three hospitals in Japan between April 2020 and March 2025. Hypnotics involved in attempts were identified from empty medication packages collected at presentation. Annual proportions of BZs and non-GABAergic hypnotics (OMs: DORAs and MRAs) were analyzed using Cochran-Armitage trend tests under three conditions: (1) all suicide attempts, (2) overdose-related attempts, and (3) overdose-related attempts involving a hypnotic. Additional analyses separated DORAs from MRAs.</p><p><strong>Results: </strong>Among 1111 suicide attempt encounters, 648 were overdose-related. OM involvement increased significantly over time across all denominators. In contrast, BZ involvement declined significantly only among overdose-related attempts. When OMs were disaggregated, DORA involvement showed a significant upward trend using overdose-related attempts as the denominator (χ² = 7.3048, p = 0.006877) and using all suicide attempts as the denominator (χ² = 7.6384, p = 0.005714). MRA (ramelteon) involvement did not show significant temporal change in either analysis. Overall, the increase in OM involvement was primarily attributable to DORAs.</p><p><strong>Conclusion: </strong>Hypnotics involved in suicide attempts changed in a context-dependent manner during the study period. The increase in non-GABAergic hypnotics was driven by DORAs, whereas reductions in BZ involvement were detectable only in overdose-related contexts. These findings suggest that evolving hypnotic availability may influence the profile of medications involved in self-poisoning.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"46 2","pages":"e70126"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Vortioxetine Prescription for Patients With Major Depressive Disorder in Japan: A Retrospective Cohort Study Using a Japanese Health Insurance Claims Database.","authors":"Masaki Kato, Tatsuya Hoshino, Yayoi Kawata, Fumie Tokuda, Shinji Fujimoto","doi":"10.1002/npr2.70133","DOIUrl":"10.1002/npr2.70133","url":null,"abstract":"<p><strong>Aim: </strong>Vortioxetine has been approved for the treatment of patients with major depressive disorder (MDD) in Japan since 2019; however, limited data are available on its use in clinical practice. This study aimed to identify real-world prescribing patterns for first-line antidepressant treatment of patients with MDD in Japan, and to understand how patient characteristics influence treatment selection and continuation.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from the JMDC claims database. Patients with MDD (aged ≥ 18 years) were included if they were newly prescribed antidepressants between November 1, 2019 and May 31, 2024. The primary outcome was the distribution of antidepressants prescribed as first-line treatment. Secondary outcomes included evaluating treatment patterns and characteristics among patients receiving a single antidepressant as first-line therapy.</p><p><strong>Results: </strong>The analysis population included 263 773 patients, of whom 97.4% had single-drug prescriptions (vortioxetine [10.2%], selective serotonin reuptake inhibitors [48.3%], serotonin-norepinephrine reuptake inhibitors [15.2%], noradrenergic and specific serotonergic antidepressants [9.8%], and other antidepressants [13.9%]), and 2.6% had multiple-drug prescriptions. Patients were less likely to be prescribed vortioxetine if they were female (odds ratio: 0.802; 95% confidence interval: 0.781-0.824) or older than 60 years (0.544; 0.498-0.594), whereas patients with somnolence (2.248; 1.152-4.385), adjustment disorders (1.488; 1.433-1.544), and nausea and vomiting (1.253; 1.194-1.315) were more likely to be prescribed vortioxetine. In the first 3 months after initiating vortioxetine treatment, 41.3% of patients continued treatment, 44.7% discontinued, and 14.0% changed treatment. Treatment change was more common in women (1.129; 1.046-1.218), and in patients with physical symptoms, whereas mental health-related comorbidities were associated with treatment persistence.</p><p><strong>Conclusion: </strong>These findings suggest that vortioxetine is more commonly prescribed to working-age men in Japan, and that patient characteristics and tolerability considerations contribute to prescribing and continuation patterns in clinical practice.</p>","PeriodicalId":19137,"journal":{"name":"Neuropsychopharmacology Reports","volume":"46 2","pages":"e70133"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}