Linden M, Thiels C
Department of Psychiatry, Free University of Berlin, Germany.
Pharmacopsychiatry. 2001 Jul;34(4):150-4. doi: 10.1055/s-2001-15880.
The pharmacology of neuroleptics as well as epidemiological and clinical observations of prescriptions of these drugs give the impression that they are and can be used for indications other than schizophrenia to a considerable degree.
We analyzed pharmacoepidemiological data on neuroleptic prescriptions in Germany. We used the following criteria: numbers of defined daily doses (DDDs) per annum, diagnoses for which they were prescribed, patient age, specialist medical training of the prescribing physician, and indicators that neuroleptics were used instead of other psychotropic drugs such as minor tranquilizers.
Only 14% of the prescriptions for neuroleptic drugs were for schizophrenic psychoses, 18% for other paranoid psychoses and 5% for affective disorders. 63% were prescribed for neurotic disorders, sleep disorders, or dementia. Almost half of the neuroleptic prescriptions were given for patients aged 65 years or over. Only 40% were prescribed by psychiatrists or neurologists. Throughout the period from 1986 to 1995, neuroleptic prescriptions increased steadily, which was paralleled by a decrease in the prescription rates for benzodiazepines.
Evaluation is urgently needed for those uses of neuroleptic drugs that, from a pharmacoepidemiological perspective, must be seen as their primary indication.
抗精神病药物的药理学以及这些药物处方的流行病学和临床观察表明，它们在很大程度上可用于精神分裂症以外的适应症。
我们分析了德国抗精神病药物处方的药物流行病学数据。我们采用了以下标准：每年限定日剂量（DDD）数、开具处方的诊断、患者年龄、开处方医生的专科医学培训，以及使用抗精神病药物而非其他精神药物（如小剂量镇静剂）的指标。
抗精神病药物处方中仅14%用于精神分裂症性精神病，18%用于其他偏执性精神病，5%用于情感障碍。63%用于神经症性障碍、睡眠障碍或痴呆。几乎一半的抗精神病药物处方是给65岁及以上患者的。只有40%是由精神科医生或神经科医生开具的。在1986年至1995年期间，抗精神病药物处方稳步增加，与此同时苯二氮䓬类药物的处方率下降。
对于抗精神病药物的那些使用情况，从药物流行病学角度来看必须视为其主要适应症，迫切需要进行评估。
