Int J Psychiatry Clin Pract. 2000;4(1):41-6. doi: 10.1080/13651500052048749.
Available efficacy data for atypical antipsychotics relate almost entirely to the use of atypicals alone. Previous surveys have, however, shown that typical antipsychotics are often co-prescribed alongside atypical drugs. We sought to evaluate prescribing of atypical antipsychotics to inpatients during one week of June 1998.
Requests for information were sent out to 229 UK centres which employed psychiatric pharmacists. From these, 143 (62%) responses were received, providing information on 3685 patients prescribed atypical antipsychotics. Data on patients prescribed an atypical for longer than 6 weeks were used as the primary indicator of prescribing practice.
For all atypicals examined, co-prescription of typical drugs was commonplace. The proportions of patients receiving an atypical as the sole antipsychotic were: clozapine 56.5%, risperidone 27.6%, sertindole 27.1%, olanzapine 18.9%, quetiapine 9.7% and amisulpride 7.1%. Patients prescribed regular typical antipsychotics alongside atypical drugs were significantly more likely to be prescribed regular anticholinergic medication, indicating higher rates of acute extrapyramidal effects in those receiving antipsychotic polypharmacy. Atypical antipsychotics were prescribed alone in a minority of patients.
Whilst there is some support for antipsychotic polypharmacy in certain cases, judging by strict evidence-based criteria the prescribing of atypical antipsychotics in our survey was poor. (Int J Psych Clin Pract 2000; 4:41-46).
现有的非典型抗精神病药物疗效数据几乎完全与单独使用非典型药物有关。然而，之前的调查显示，典型抗精神病药物常常与非典型药物一起开处方。我们试图评估 1998 年 6 月一周内住院患者使用非典型抗精神病药物的情况。
向 229 家雇用精神科药剂师的英国中心发出信息请求。其中 143 家（62%）做出了回应，提供了 3685 名开处方使用非典型抗精神病药物的患者的信息。将患者服用非典型药物超过 6 周的数据作为开处方做法的主要指标。
在所检查的所有非典型药物中，典型药物的联合处方非常普遍。单独使用非典型药物的患者比例为：氯氮平 56.5%，利培酮 27.6%，齐拉西酮 27.1%，奥氮平 18.9%，喹硫平 9.7%和氨磺必利 7.1%。同时开处方使用常规典型抗精神病药物和非典型药物的患者更有可能被开处方使用常规抗胆碱能药物，这表明那些接受抗精神病药物联合用药的患者出现急性锥体外系副作用的比率更高。只有少数患者单独使用非典型抗精神病药物。
虽然在某些情况下有一定的支持抗精神病药物联合用药的证据，但根据严格的循证标准，我们的调查中使用非典型抗精神病药物的情况不佳。（《国际精神病临床实践杂志》2000 年；4 期：41-46）。
