Ndukwe Henry C, Tordoff June M, Wang Ting, Nishtala Prasad S
School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
Drugs Aging. 2014 Oct;31(10):755-68. doi: 10.1007/s40266-014-0205-1.
Psychotropic medicine utilization has increased worldwide among older people (aged 65 years or older), in relation to utilization of other medicines.
The aim of this population-level study was to describe and characterize the national utilization of psychotropic medicines in older people in New Zealand between 2005 and 2013.
Repeated cross-sectional analysis of population-level dispensing data was conducted from 1 January 2005 to 31 December 2013. Data on utilization of psychotropic medicines were extracted and categorized in accordance with the World Health Organization Collaborating Centre for Drug Statistics Methodology's Anatomical Therapeutic Chemical classification system. Utilization was measured in terms of the defined daily dose (DDD) per 1,000 older people per day (TOPD).
Overall, utilization of psychotropic medicines showed a 22.5 % increase between 2005 and 2013. Utilization increased for antidepressants (from 81.9 to 110.4 DDD/TOPD), antipsychotics (from 6.8 to 8.7 DDD/TOPD) and hypnotics and sedatives (from 59.4 to 65.5 DDD/TOPD); in contrast, utilization of anxiolytics decreased (from 11.4 to 10.7 DDD/TOPD). Utilization of atypical antipsychotics increased (from 4.6 to 6.8 DDD/TOPD), with the highest percentage change in DDD/TOPD being contributed by olanzapine (112.1 %), while utilization of typical antipsychotics declined (from 2.0 to 1.5 DDD/TOPD). Utilization of tetracyclic antidepressants and venlafaxine grew rapidly by 1.5 and 4.5 times, respectively, between 2005 and 2013. Utilization of zopiclone was greater than that of other hypnotics in 2013.
Utilization of psychotropic medicines in older people increased by one fifth between 2005 and 2013. Important findings of this study were that: (1) there was a marked increase in utilization of recently funded antidepressants; (2) utilization of atypical antipsychotics increased; (3) there was a move towards utilization of selective serotonin reuptake inhibitors; (4) utilization of zopiclone remained high; and (5) low, standard and high DDD utilization all increased with time.
与其他药物的使用情况相比，精神药物在全球范围内的老年人（65岁及以上）中的使用有所增加。
这项基于人群的研究旨在描述和刻画2005年至2013年期间新西兰老年人精神药物的全国使用情况。
对2005年1月1日至2013年12月31日期间的人群层面配药数据进行重复横断面分析。提取精神药物使用数据，并根据世界卫生组织药物统计方法合作中心的解剖治疗化学分类系统进行分类。使用情况以每天每1000名老年人的限定日剂量（DDD）来衡量（TOPD）。
总体而言，2005年至2013年期间精神药物的使用增加了22.5%。抗抑郁药的使用增加（从81.9 DDD/TOPD增至110.4 DDD/TOPD）、抗精神病药（从6.8 DDD/TOPD增至8.7 DDD/TOPD）以及催眠药和镇静剂（从59.4 DDD/TOPD增至65.5 DDD/TOPD）；相比之下，抗焦虑药的使用减少（从11.4 DDD/TOPD降至10.7 DDD/TOPD）。非典型抗精神病药的使用增加（从4.6 DDD/TOPD增至6.8 DDD/TOPD），其中奥氮平的DDD/TOPD变化百分比最高（112.1%），而典型抗精神病药的使用下降（从2.0 DDD/TOPD降至1.5 DDD/TOPD）。2005年至2013年期间，四环类抗抑郁药和文拉法辛的使用分别迅速增长了1.5倍和4.5倍。2013年佐匹克隆的使用量高于其他催眠药。
2005年至2013年期间老年人精神药物的使用增加了五分之一。这项研究的重要发现包括：（1）近期资助的抗抑郁药使用显著增加；（2）非典型抗精神病药的使用增加；（3）有向选择性5-羟色胺再摄取抑制剂使用转变的趋势；（4）佐匹克隆的使用量仍然很高；（5）低、标准和高DDD使用量均随时间增加。
