Wheeler Amanda
Clinical Research and Resource Centre, Waitemata District Health Board, PO Box 44055, Pt Chevalier, Auckland 1246.
N Z Med J. 2006 Jul 7;119(1237):U2055.
To outline the prescribing patterns of atypical antipsychotics for adult mental health outpatients in Auckland and Northland in 2004.
All community files were reviewed retrospectively (n = 6165). Patient characteristics, diagnosis, and antipsychotic and concurrent medication were recorded and analysed.
Overall, 71.3% of outpatients were prescribed an antipsychotic, of which 82.5% were atypicals: oral risperidone (30.9%), olanzapine (30.3%), quetiapine (17.1%), clozapine (26.3%), and depot risperidone (0.4%). Psychotic disorders accounted for 73.2% of outpatients on atypicals, and schizophrenia was the most common disorder overall (62.5%). Combination antipsychotic treatment occurred in 13.5% of those prescribed atypicals; 4.8% had another atypical and 8.7% had a typical co-prescribed. Clozapine was least likely to be combined with a typical antipsychotic. Those receiving combination typical and atypical antipsychotics had a greater likelihood of being prescribed an anticholinergic medication.
Atypical antipsychotics are the preferred treatment for outpatients with psychotic illness and are being prescribed in a manner consistent with clinical practice guidelines. Co-prescribing of antipsychotics was low, but may be causing unnecessary adverse effects and risks.
概述2004年奥克兰和北地地区成年心理健康门诊患者非典型抗精神病药物的处方模式。
对所有社区档案进行回顾性审查（n = 6165）。记录并分析患者特征、诊断、抗精神病药物及合并用药情况。
总体而言，71.3%的门诊患者开具了抗精神病药物，其中82.5%为非典型药物：口服利培酮（30.9%）、奥氮平（30.3%）、喹硫平（17.1%）、氯氮平（26.3%）和长效利培酮（0.4%）。患有精神障碍的患者占使用非典型药物门诊患者的73.2%，精神分裂症是最常见的疾病（62.5%）。13.5%使用非典型药物的患者接受了联合抗精神病治疗；4.8%的患者同时使用了另一种非典型药物，8.7%的患者同时使用了一种典型药物。氯氮平与典型抗精神病药物联合使用的可能性最小。接受典型和非典型抗精神病药物联合治疗的患者更有可能开具抗胆碱能药物。
非典型抗精神病药物是精神病患者门诊治疗的首选药物，其处方方式符合临床实践指南。抗精神病药物的联合处方率较低，但可能会导致不必要的不良反应和风险。
