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新西兰坎特伯雷地区非典型抗精神病药物的超说明书用药情况。

Off-label use of atypical antipsychotic medications in Canterbury, New Zealand.

作者信息

Monasterio Erik, McKean Andrew

机构信息

University of Otago and Hillmorton Hospital, Christchurch, New Zealand.

出版信息

N Z Med J. 2011 Jun 10;124(1336):24-9.

Abstract

AIM

To estimate the frequency and characteristics of "off-label" use of atypical antipsychotic medications (AAPs) by psychiatrists in Canterbury, New Zealand.

METHODS

Data on "off-label" prescribing of AAPs including the choice of medication, frequency of prescribing, and the indications for its use was collected using a postal survey of psychiatrists registered with the NZ Medical Council in the Canterbury region.

RESULTS

48 psychiatrists (71%) completed the survey. Forty-six (96%) prescribed AAPs "off-label". By far the most common agent was quetiapine (94%). Twenty-eight respondents (58%) prescribed "off-label" at least once a week. The most common reasons for the use of these agents was: anxiety (89%), sedation (79%), post-traumatic stress disorder (57%), treatment augmentation of another antipsychotic agent (48%) and behavioural and psychological symptoms of dementia (33%).

CONCLUSION

"Off-label" prescribing, particularly of quetiapine is very common in the Canterbury region, despite little scientific evidence for this kind of use, increasing evidence of abuse and potential for significant side-effects.

摘要

目的

评估新西兰坎特伯雷地区精神科医生使用非典型抗精神病药物(AAPs)进行“超说明书用药”的频率及特点。

方法

采用邮寄调查问卷的方式,收集在坎特伯雷地区新西兰医学委员会注册的精神科医生关于AAPs“超说明书用药”的数据,包括药物选择、用药频率及其使用指征。

结果

48名精神科医生(71%)完成了调查。46名(96%)医生开具了AAPs的“超说明书用药”。到目前为止,最常用的药物是喹硫平(94%)。28名受访者(58%)每周至少进行一次“超说明书用药”。使用这些药物最常见的原因是:焦虑(89%)、镇静(79%)、创伤后应激障碍(57%)、增强另一种抗精神病药物的治疗效果(48%)以及痴呆的行为和心理症状(33%)。

结论

在坎特伯雷地区,“超说明书用药”,尤其是喹硫平的“超说明书用药”非常普遍,尽管此类用药几乎没有科学依据,且滥用证据不断增加并有产生严重副作用的可能性。

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