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[精神科的药物制剂与药物治疗依从性:以奥氮平口腔崩解片为例]

[Pharmaceutical formulations and adherence to pharmacological treatment in psychiatry: the example of oral disintegrating tablet of olanzapine].

作者信息

Cecchi Cristiana, Canonico Pier Luigi

机构信息

Salute Mentale Adulti, ASL, Firenze.

出版信息

Riv Psichiatr. 2012 Jan-Feb;47(1):30-9. doi: 10.1708/1034.11289.

Abstract

Adherence to treatment in psychiatric as in other chronic or recurrent conditions, is often suboptimal. A high proportion of relapses is due to non-adherence to prescribed treatment. Adherence to treatment is a potent predictor of effectiveness, both in clinical trials and cohort studies, therefore is a very relevant area where any improving tool is looked forward. Orally Disintegrating Tablets (ODT) were developed with the aim to improve patient's compliance due to their fast oral absorption. They are particularly useful in psychiatric patients who often simulate drug assumption or experience difficulties in taking pills. ODT formulations have been developed for many antypsychotics including olanzapine. The ODT formulations of olanzapine show to be significantly different one from the other in the dissolution time, thus having a potential impact on compliance. In this review, the results of different studies consistently highlight the positive risk/benefit profile, the contribution to patient's compliance and their preference while using ODT formulation of olanzapine produced throughout the ZYDIS technology (Velotab). Moreover, the differences between olanzapine ODT (Velotab) and the standard formulation of olanzapine and other antipsychotics are described focusing on in efficacy, safety, patient acceptance and health economic impact. The ODT formulation of olanzapine (Velotab) seems to ameliorate patient's adherence thus improving psychiatrist/caregiver/patient alliance.

摘要

与其他慢性或复发性疾病一样,精神科治疗的依从性往往不尽人意。高比例的复发是由于未坚持规定的治疗。在临床试验和队列研究中,治疗依从性都是疗效的有力预测指标,因此是一个非常值得关注的领域,人们期待有任何改进工具。口腔崩解片(ODT)的研发旨在因其快速的口服吸收而提高患者的依从性。它们对经常假装服药或吞服药片有困难的精神科患者特别有用。已经为包括奥氮平在内的许多抗精神病药物开发了ODT制剂。奥氮平的ODT制剂在溶出时间上彼此有显著差异,因此对依从性有潜在影响。在本综述中,不同研究的结果一致突出了通过ZYDIS技术(Velotab)生产的奥氮平ODT制剂的积极风险/效益概况、对患者依从性的贡献以及患者使用时的偏好。此外,还描述了奥氮平ODT(Velotab)与奥氮平标准制剂及其他抗精神病药物在疗效、安全性、患者接受度和卫生经济影响方面的差异。奥氮平(Velotab)的ODT制剂似乎改善了患者的依从性,从而改善了精神科医生/护理人员/患者之间的关系。

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