INSERM U657, Université Victor Segalen, Bordeaux 2, France.
Pharmacopsychiatry. 2010 Jan;43(1):17-23. doi: 10.1055/s-0029-1237396. Epub 2009 Dec 10.
Little information is available on the pattern of use of antipsychotics in naturalistic conditions in persons initially treated with "conventional" mood stabilizers (lithium and anticonvulsants).
Data on community prescriptions were extracted from the 2004-2006 claims database of a French health care insurance fund for self-employed workers. Patients included were those continuously exposed to mood stabilizers without concomitant dispensing of antipsychotics over at least a 3-month period.
Of the 3 958 persons included, 17.8% had at least one addition/switch to antipsychotics over the follow-up period. The most frequent pattern was addition of second-generation antipsychotics (SGAPs) (41%) or first-generation antipsychotics (FGAPs) (23%) to the mood stabilizer for a relatively short period of time. A switch from mood stabilizer to SGAPs (20%) or FGAPs (15%) was less frequent. Mood stabilizers alone were prescribed again in most patients with the addition of FGAPs (72%) or SGAPs (61%) to mood stabilizers. Conversely, the majority of patients with a switch from mood stabilizers to FGAPs (55%) or SGAPs (58%) went on with these latter treatments over the follow-up.
SGAPs are preferentially prescribed in combination with mood stabilizers and their pattern of use is similar to that of FGAPs.
在最初使用“常规”心境稳定剂（锂盐和抗惊厥药）治疗的患者中，有关抗精神病药在自然环境下使用模式的信息很少。
从 2004 年至 2006 年法国自营职业者医疗保险基金的索赔数据库中提取了社区处方数据。纳入的患者在至少 3 个月的时间内持续暴露于心境稳定剂，同时未同时配用抗精神病药。
在纳入的 3958 名患者中，有 17.8％在随访期间至少有一次加用/改用抗精神病药。最常见的模式是在相对较短的时间内将第二代抗精神病药（SGAPs）（41％）或第一代抗精神病药（FGAPs）（23％）加用至心境稳定剂。从心境稳定剂换用 SGAPs（20％）或 FGAPs（15％）的情况较少见。大多数加用 FGAPs（72％）或 SGAPs（61％）至心境稳定剂的患者再次单独开用心境稳定剂。相反，大多数从心境稳定剂换用 FGAPs（55％）或 SGAPs（58％）的患者在随访期间继续使用这些药物。
SGAPs 优先与心境稳定剂联合开处方，其使用模式与 FGAPs 相似。
