Bitter I, Chou J C-Y, Ungvari G S, Tang W K, Xiang Z, Iwanami A, Gaszner P
Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
Pharmacopsychiatry. 2003 Jul;36(4):143-9. doi: 10.1055/s-2003-41199.
This study compares prescription practices for acute inpatients with schizophrenia among six academic departments located in China, Japan, Hungary, and the U.S.
Prescription data for a sample of 429 inpatients from six academic departments were collected on a randomly chosen census day. All patients met criteria for schizophrenia according to DSM-IV and had a length of illness of at least two years.
While patients at the different centers varied in their demographic and clinical characteristics, i. e., age, sex, and length of illness, a great variation in prescription patterns for antipsychotic and other psychotropic drugs among centers was observed even within the same country for all the variables studied (i. e., number and dose antipsychotics, atypical and depot antipsychotics, other psychotropic drugs, multiple antipsychotics, and daily dose) except antidepressant use. In most cases these differences persisted even after adjusting for demographic and clinical characteristics (age, sex, and length of illness) of the subjects. Antipsychotics were usually prescribed in divided daily doses in combination with one or more other psychotropic drugs, including anticholinergics, anticonvulsants, benzodiazepines, and non-benzodiazepine hypnotics. Anticholinergic use was more common with typical antipsychotics. Rates of atypical antipsychotic drug use were lowest in the Japanese center. The Japanese center had by far the highest mean daily dose of antipsychotics.
The results indicate that prescription patterns in different centers do not follow any specific guidelines for the treatment of schizophrenia. The results also confirm previous findings that prescribing practices for schizophrenia vary greatly among centers and countries. A common prescribing pattern found was the use of atypical antipsychotic drugs in combination with psychotropic drugs, such as anticholinergics, hypnotics, anticonvulsants, and benzodiazepines, administered in multiple daily doses.
本研究比较了位于中国、日本、匈牙利和美国的六个学术科室中急性精神分裂症住院患者的处方习惯。
在随机选择的普查日收集了来自六个学术科室的429名住院患者的处方数据。所有患者均符合《精神疾病诊断与统计手册》第四版（DSM-IV）中精神分裂症的标准，且病程至少两年。
虽然不同中心的患者在人口统计学和临床特征（即年龄、性别和病程）方面存在差异，但即使在同一国家内，在所研究的所有变量（即抗精神病药物和其他精神药物的数量和剂量、非典型和长效抗精神病药物、其他精神药物、多种抗精神病药物以及每日剂量）中，各中心之间抗精神病药物和其他精神药物的处方模式仍存在很大差异，但抗抑郁药的使用情况除外。在大多数情况下，即使在调整了受试者的人口统计学和临床特征（年龄、性别和病程）后，这些差异仍然存在。抗精神病药物通常以每日分次剂量与一种或多种其他精神药物联合使用，包括抗胆碱能药物、抗惊厥药物、苯二氮䓬类药物和非苯二氮䓬类催眠药。抗胆碱能药物在使用典型抗精神病药物时更为常见。日本中心非典型抗精神病药物的使用率最低。日本中心的抗精神病药物平均每日剂量是所有中心中最高的。
结果表明，不同中心的处方模式并未遵循任何特定的精神分裂症治疗指南。结果还证实了先前的研究发现，即精神分裂症的处方习惯在不同中心和国家之间存在很大差异。发现的一种常见处方模式是使用非典型抗精神病药物与精神药物联合使用，如抗胆碱能药物、催眠药、抗惊厥药物和苯二氮䓬类药物，每日分多次给药。
