Department of Pharmacy, Faculty of Health Sciences, Oslo University College, Pilestredet 50, 0167, Oslo, Norway.
Eur J Clin Pharmacol. 2010 Nov;66(11):1151-60. doi: 10.1007/s00228-010-0861-y. Epub 2010 Jul 29.
Patients with epilepsy often suffer from concomitant psychiatric disorders. Treatment patterns and the extent of comorbidity are insufficiently investigated and appropriate methods are scarce. The purpose of the study was to estimate the prevalence of psychiatric comorbidity in patients with epilepsy and to investigate prescription patterns of drugs prescribed for psychiatric disorders in epilepsy.
Prescription data from the Norwegian Prescription Database (NorPD) regarding the use of CNS-active drugs included anonymous data from almost 190,000 patients and 1.1-1.3 million prescriptions per year (2004-2007). Searches were based upon use of specific drugs, defined daily doses, number of patients, prescriptions, gender, and age. Reimbursement codes related to psychiatric diagnosis were used as indicators for clinical use.
The prevalence of psychiatric comorbidity in patients with epilepsy was estimated to be 32%. There were 56% women and 44% men participating in the study. Among patients using antidepressants two thirds were women, but no gender differences were seen with antipsychotic medication. Antidepressants and antipsychotics were used 3.4 (20.9%) and 5.8 (13.4%) times more frequently than in the general population, accounting for 7.88 and 1.99 defined daily doses (DDDs)/1,000 inhabitants/day/year respectively. Lamotrigine was the most commonly used antiepileptic drug (AED) in epilepsy, accounting for 33% of the use of AEDs (in total 5.65 DDDs/1,000 inhabitants/day/year). The use of benzodiazepines was 9.55 DDDs/1,000 inhabitants/day/year. The patients had complex pharmacotherapy with two to eight concomitant drugs.
The present study gives an estimate of psychiatric comorbidity of 32% in patients with epilepsy in a nation-wide population. The pharmacotherapy in this patient population is complex. The results provide valuable data on prescription patterns that contribute to pharmacovigilance on a national scale.
癫痫患者常伴有精神疾病。目前对治疗模式和合并症的严重程度研究不足，且缺乏适当的治疗方法。本研究旨在评估癫痫患者伴发精神疾病的患病率，并研究抗癫痫药物治疗精神疾病的处方模式。
我们使用挪威处方数据库（NorPD）中关于中枢神经系统药物使用情况的处方数据，这些数据来自近 19 万名患者和每年 110 至 130 万张处方（2004-2007 年）。搜索基于特定药物的使用、定义日剂量、患者人数、处方、性别和年龄。使用与精神科诊断相关的报销代码作为临床使用的指标。
癫痫患者伴发精神疾病的患病率估计为 32%。研究人群中 56%为女性，44%为男性。使用抗抑郁药的患者中，三分之二为女性，但使用抗精神病药物的患者中无性别差异。抗抑郁药和抗精神病药的使用频率分别比普通人群高 3.4 倍（20.9%）和 5.8 倍（13.4%），相应的定义日剂量（DDD）分别为 7.88 和 1.99 DDD/每 1000 居民/天/年。拉莫三嗪是最常用于癫痫的抗癫痫药物（AED），占 AED 使用的 33%（总使用量为 5.65 DDD/每 1000 居民/天/年）。苯二氮䓬类药物的使用量为 9.55 DDD/每 1000 居民/天/年。患者的药物治疗方案复杂，同时使用 2 至 8 种伴随药物。
本研究在全国范围内估计癫痫患者的精神疾病患病率为 32%。该患者人群的药物治疗方案复杂。研究结果提供了有关处方模式的有价值数据，有助于在全国范围内进行药物警戒。
