Pharmacy Department, Maudsley Hospital, London, UK.
Int J Psychiatry Clin Pract. 2005;9(2):124-9. doi: 10.1080/13651500510028995.
Objective : In the United Kingdom (UK) the National Institute for Clinical Excellence (NICE) has recommended the use of atypical antipsychotics for the treatment of schizophrenia. As part of its guidance it discourages the concurrent use of typical and atypical antipsychotics. In previous prescribing surveys antipsychotic polypharmacy has been noted to be widespread. We sought to evaluate atypical antipsychotic prescribing after the publication of NICE guidance. Method : We invited psychiatric centres in England and Wales to participate, in March 2004, in an atypical antipsychotic prescribing survey of hospital in-patients. Results : Thirty-six in-patient units submitted data for 2012 patients. After exclusions, 1092 patients were eligible. Of these, 28.6% (312) were prescribed a typical alongside an atypical antipsychotic and 19.3% (211) were prescribed high-dose antipsychotics. Co-prescription was more prevalent in patients aged 40 years and above (32.0 vs. 25.3%; P=0.018). It was also noted that in centres employing senior pharmacists, co-prescription was more common (28.6 vs. 14.3%; P=0.03). High-dose treatment was more commonly observed in patients of a white ethnic background (20.6 vs. 13.9%; P=0.02) as well as in patients aged 40 years and above (24.4 vs. 15.0%; P<0.001). Prescription of anticholinergics was significantly more prevalent in those receiving atypical and typical combinations than atypicals alone (26.0 vs. 12.0%; P<0.001). Conclusions : Antipsychotic polypharmacy remains commonplace. Similarly the prescription of high-dose antipsychotics is also widespread.
在英国（UK），国家临床卓越研究所（NICE）建议使用非典型抗精神病药治疗精神分裂症。作为其指导的一部分，它不鼓励同时使用典型和非典型抗精神病药。在之前的处方调查中，抗精神病药的联合用药已被广泛报道。我们试图在 NICE 指南发布后评估非典型抗精神病药的处方情况。
我们邀请英格兰和威尔士的精神病中心于 2004 年 3 月参与一项非典型抗精神病药住院患者处方调查。
36 个住院病房提交了 2012 名患者的数据。排除后，有 1092 名患者符合条件。其中，28.6%（312 名）同时开了一种典型和一种非典型抗精神病药，19.3%（211 名）开了高剂量抗精神病药。在 40 岁及以上的患者中，联合用药更为常见（32.0%比 25.3%；P=0.018）。还注意到，在雇佣资深药剂师的中心，联合用药更为常见（28.6%比 14.3%；P=0.03）。高剂量治疗在白种人患者中更为常见（20.6%比 13.9%；P=0.02），在 40 岁及以上的患者中也更为常见（24.4%比 15.0%；P<0.001）。与单独使用非典型药物相比，同时使用非典型和典型药物的患者抗胆碱能药物的处方更为常见（26.0%比 12.0%；P<0.001）。
抗精神病药联合用药仍然很常见。同样，高剂量抗精神病药的处方也很普遍。
