Department of Psychiatry and Psychotherapy, Charité Campus Mitte Universitätsmedizin Berlin, Germany.
Pharmacoepidemiol Drug Saf. 2012 Feb;21(2):145-51. doi: 10.1002/pds.2166. Epub 2011 Jul 1.
Little is known about psychopharmacological prescription practice in low-income countries. The present study aimed for an analysis of pharmacological treatment strategies for inpatients with schizophrenia in Tashkent, the capital city of Uzbekistan, facing a low-income situation as compared with four German cities in a high-income Western situation.
We conducted a cross-sectional quantitative survey of age, gender, diagnoses, and psychotropic medication of 845 urban psychiatric inpatients of the Tashkent psychiatric hospital and of 922 urban psychiatric inpatients in four German cities on 1 day in October 2008. We compared the current treatment strategies for specific diagnostic categories between the two settings.
In Tashkent, patients diagnosed with schizophrenia were treated with clozapine (66%), haloperidol (62%), or both (44%). More than one-third of the patients treated for schizophrenia were prescribed amitriptyline. The usual treatment strategy for schizophrenia was the combination of two or more antipsychotics (67%). In German cities, the preferred antipsychotics for the treatment of schizophrenia were olanzapine (21%), clozapine (20%), quetiapine (17%), risperidone (17%), and haloperidol (14%); the most common treatment strategy for patients with schizophrenia was the combination of antipsychotics and benzodiazepines; 44% of the patients were treated with two or more antipsychotics at a time.
In both settings, psychotropic combination treatments are common for the treatment of schizophrenia contrasting current guideline recommendations. Its rationale and effectiveness needs to be tested in further studies.
在低收入国家，人们对精神药理学处方实践知之甚少。本研究旨在分析乌兹别克斯坦首都塔什干的住院精神分裂症患者的药物治疗策略，与德国四个高收入城市相比，塔什干的情况是低收入。
我们对 2008 年 10 月 1 日塔什干精神病院的 845 名城市住院精神病患者和德国四个城市的 922 名城市住院精神病患者的年龄、性别、诊断和精神药物进行了横断面定量调查。我们比较了两种环境下特定诊断类别的当前治疗策略。
在塔什干，诊断为精神分裂症的患者接受氯氮平（66%）、氟哌啶醇（62%）或两者（44%）治疗。超过三分之一的精神分裂症患者服用阿米替林。精神分裂症的常用治疗策略是联合使用两种或两种以上的抗精神病药物（67%）。在德国城市，治疗精神分裂症的首选抗精神病药物为奥氮平（21%）、氯氮平（20%）、喹硫平（17%）、利培酮（17%）和氟哌啶醇（14%）；精神分裂症患者最常见的治疗策略是抗精神病药物与苯二氮䓬类药物联合使用；44%的患者同时接受两种或两种以上的抗精神病药物治疗。
在这两种环境下，精神药物联合治疗是治疗精神分裂症的常见方法，与当前的指南建议形成对比。需要进一步的研究来检验其合理性和有效性。
