Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Int J Neuropsychopharmacol. 2012 May;15(4):449-57. doi: 10.1017/S1461145711000745. Epub 2011 May 17.
While international guidelines recommend monotherapy with antidepressants for depressed patients, recent investigation has demonstrated augmenting effects of antipsychotics (APs) in patients with major depression. We set out to investigate the use of APs in a European sample of depressed inpatients and the possible changes in their prescription over the period from 2000 to 2007. On two reference days in the years 2000 (32 psychiatric institutions, N=1078) and 2007 (54 psychiatric institutions, N=1826), the following data were recorded for all depressed inpatients (ICD-10: F32.00, F32.01, F32.1, F32.10, F32.11, F32.2, F33.0, F33.00, F33.01, F33.1, F33.10, F33.11, F33.2), monitored as part of the AMSP (Arzneimittelsicherheit in der Psychiatrie) surveillance programme: age, sex, ICD-10 diagnosis and all medication applied on that day. Depressed inpatients with psychotic symptoms were excluded. We found a significant increase in the number of AP-treated inpatients from 37.9% in 2000 to 45.8% in 2007 (χ²=17.257, p<0.001). The number of inpatients who received an atypical AP rose significantly between 2000 and 2007, from 12.8% to 28.3% (χ²=93.37, p<0.001). On the contrary, the percentage of inpatients receiving typical APs showed a significant decrease from 30.2% to 24.1% over the same period (χ²=13.179, p<0.001). Examining only the subgroup of severely depressed inpatients we found an increase in the number of AP-treated inpatients, but this was not statistically significant (χ²=2.047, p=0.15). Our study revealed a significant increase in the usage of atypical APs. However, this effect was not only due to augmentation strategies for severely depressed inpatients. Further studies are needed to examine possible putative effects of AP augmentation treatment in mild to moderate depression.
虽然国际指南建议对抑郁症患者进行抗抑郁药单药治疗，但最近的研究表明，抗精神病药 (APs) 对重度抑郁症患者有增效作用。我们着手调查了在欧洲抑郁症住院患者中使用 APs 的情况，以及 2000 年至 2007 年期间其处方的可能变化。在 2000 年（32 家精神病院，N=1078）和 2007 年（54 家精神病院，N=1826）的两个参考日，记录了所有抑郁症住院患者（ICD-10：F32.00、F32.01、F32.1、F32.10、F32.11、F32.2、F33.0、F33.00、F33.01、F33.1、F33.10、F33.11、F33.2）的以下数据，这些患者作为 AMSP（精神病学药物安全）监测计划的一部分进行监测：年龄、性别、ICD-10 诊断和当天使用的所有药物。排除有精神病症状的抑郁症住院患者。我们发现，接受 AP 治疗的住院患者人数从 2000 年的 37.9%显著增加到 2007 年的 45.8%（χ²=17.257，p<0.001）。2000 年至 2007 年间，接受非典型 AP 的住院患者数量显著增加，从 12.8%增加到 28.3%（χ²=93.37，p<0.001）。相反，同期接受典型 AP 的住院患者比例从 30.2%显著下降到 24.1%（χ²=13.179，p<0.001）。仅检查重度抑郁症住院患者亚组，我们发现接受 AP 治疗的住院患者数量增加，但这并不具有统计学意义（χ²=2.047，p=0.15）。我们的研究显示，非典型 AP 的使用显著增加。然而，这种效果不仅是由于对重度抑郁症住院患者的增效策略。需要进一步研究来检查 AP 增效治疗在轻度至中度抑郁症中的可能潜在作用。
