Taylor David, Hayhurst Karen, Kerwin Robert
Pharmacy Department, Maudsley Hospital, London, UK.
Int Clin Psychopharmacol. 2007 May;22(3):133-6. doi: 10.1097/YIC.0b013e3280148219.
Second-generation antipsychotics are now treatments of choice in many countries. In this study, we aimed to compare hospital stay and admissions to hospital in patients switching from first-generation (conventional) to second-generation (atypical) antipsychotics with patients switching from one first-generation drug to another. This was a retrospective, 6-year, controlled mirror-image study conducted in an acute general psychiatry services in an inner-city area. Subjects were consisted of patients diagnosed with schizophrenia or schizoaffective disorder receiving continuous prescription of antipsychotics over at least a 6-year period between 1994 and 2002. The main outcome measures were number of days spent in hospital and number of admissions to hospital. In 36 patients switched from first to second-generation antipsychotics, total number of days spent in hospital increased, from a mean of 90 days in the 3 years before switching, to a mean of 200 days in the 3 years after (P<0.001). Mean number of admissions did not change significantly (1.61 before vs. 1.44 after, P=0.360). In 36 matched control patients, switching between first-generation antipsychotic drugs, mean number of days in hospital fell from 64 to 50 (P=0.189) and number of admissions was virtually unchanged (1.42 before vs. 1.03 after, P=0.202). Mean days in hospital were significantly increased in the second-generation antipsychotic group compared with the first-generation antipsychotic (control) group (P<0.001). Switching from first to second-generation antipsychotics resulted in an important increase in number of days spent in hospital. Switching from one first-generation antipsychotic drug to another did not significantly affect number of days in hospital.
第二代抗精神病药物如今在许多国家都是首选治疗药物。在本研究中，我们旨在比较从第一代（传统）抗精神病药物转换为第二代（非典型）抗精神病药物的患者与从一种第一代药物转换为另一种第一代药物的患者的住院时间和住院次数。这是一项在市中心地区的急性普通精神病服务机构中进行的回顾性、为期6年的对照镜像研究。研究对象包括在1994年至2002年期间至少连续6年接受抗精神病药物处方治疗的精神分裂症或分裂情感性障碍患者。主要观察指标为住院天数和住院次数。在36例从第一代抗精神病药物转换为第二代抗精神病药物的患者中，住院总天数增加，从转换前3年的平均90天增加到转换后3年的平均200天（P<0.001）。平均住院次数没有显著变化（转换前为1.61次，转换后为1.44次，P = 0.360）。在36例匹配的对照患者中，第一代抗精神病药物之间的转换使平均住院天数从64天降至50天（P = 0.189），住院次数基本未变（转换前为1.42次，转换后为1.03次，P = 0.202）。与第一代抗精神病药物（对照）组相比，第二代抗精神病药物组的平均住院天数显著增加（P<0.001）。从第一代抗精神病药物转换为第二代抗精神病药物导致住院天数显著增加。从一种第一代抗精神病药物转换为另一种第一代抗精神病药物对住院天数没有显著影响。
