Parepally Haranath, Chakravorty Sudeep, Levine Joseph, Brar Jaspreet S, Patel Amit M, Baird James W, Chalasani Lokaranjit, Delaney Joyce A, Atzert Rebecca, Chengappa K N Roy
Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA.
Prog Neuropsychopharmacol Biol Psychiatry. 2002 Apr;26(3):437-40. doi: 10.1016/s0278-5846(01)00279-2.
Concomitant medications are frequently used in the treatment of resistant psychiatric conditions to augment the primary psychotropic agent or to ameliorate side effects. The present study evaluated the prescription of concomitant psychiatric medications for psychiatric inpatients that were prescribed either olanzapine at its first commercial availability or another first-line antipsychotic agent. Sixty-nine newly admitted patients (mainly with schizophrenia) who were prescribed either olanzapine (n = 35) or another first-line antipsychotic agent (n = 34) were assessed (for the prescription of other concomitant psychotropic drugs) before (2-4 weeks prior to study) and following 8 weeks of treatment (unless discharged sooner). The results indicate that significantly fewer olanzapine-treated subjects were prescribed anticholinergic agents as compared to those prescribed other first-line antipsychotic agents, and a similar trend was noted in the prescription of mood stabilizers as well. Olanzapine-treated subjects used less as needed (PRN) antipsychotic medication compared to pre-olanzapine treatment period. Olanzapine-treated subjects used more anxiolytic agents compared to the control group in the early stages of treatment, probably due to the greater baseline severity of illness. These data suggest that olanzapine use is associated with less use of anticholinergic and mood-stabilizing agents as compared to older antipsychotic agents. These results also suggest that there is less need for PRN antipsychotic medication following olanzapine treatment. More severely ill subjects may require more anxiolytics during olanzapine initiation. The need for less anticholinergic and mood-stabilizing agent use with olanzapine could lead to greater adherence to long-term treatment and perhaps decreased cost (i.e. use of blood and organ system monitoring with mood stabilizers). At the end of treatment, olanzapine-treated subjects had statistically significantly lesser concomitant medicine usage compared to control subjects.
在难治性精神疾病的治疗中，常常会联合使用药物来增强主要精神药物的疗效或减轻副作用。本研究评估了首次上市时使用奥氮平或其他一线抗精神病药物的精神科住院患者联合使用精神药物的处方情况。对69名新入院患者（主要为精神分裂症患者）进行了评估，这些患者被处方了奥氮平（n = 35）或其他一线抗精神病药物（n = 34），在治疗前（研究前2 - 4周）以及治疗8周后（除非提前出院）评估（其他联合使用的精神药物的处方情况）。结果表明，与使用其他一线抗精神病药物的患者相比，使用奥氮平治疗的患者中被处方抗胆碱能药物的人数显著更少，在心境稳定剂的处方方面也观察到了类似趋势。与奥氮平治疗前相比，使用奥氮平治疗的患者按需使用抗精神病药物的量更少。在治疗早期，与对照组相比，使用奥氮平治疗的患者使用更多的抗焦虑药物，这可能是由于疾病的基线严重程度更高。这些数据表明，与 older抗精神病药物相比，使用奥氮平与抗胆碱能药物和心境稳定剂的使用减少有关。这些结果还表明，奥氮平治疗后按需使用抗精神病药物的需求减少。病情较重的患者在奥氮平治疗初期可能需要更多的抗焦虑药物。奥氮平使用时对抗胆碱能药物和心境稳定剂的需求减少，可能会导致对长期治疗的依从性更高，或许还能降低成本（即使用心境稳定剂时进行血液和器官系统监测）。在治疗结束时，与对照组相比，使用奥氮平治疗的患者联合用药的使用量在统计学上显著更少。
