Martínez-Lazcano M Teresa, Esplá-González Sara, Herraiz-Robles Paola, Hernández-Pérez Pilar, Chillerón-Cuenca Raquel, Pol-Yanguas Emilio
Hospital Universitario Sant Joan D'Alacant..
Licenciada en Farmacia..
Farm Hosp. 2015 Mar 1;39(2):92-101. doi: 10.7399/fh.2015.39.2.8460.
Valproic acid is often used in psychiatry to treat schizophrenia and other conditions outside of indication ("off-label"). However, its effectiveness has not been sufficiently demonstrated and its use is not exempt of adverse effects. This study's main objective is to determine the frequency of use of valproic acid in approved indications and the "off-label" use in psychiatric patients.
A cross-sectional study on July 7, 2014 with a sample of 167 patients residents in a psychiatric center was designed. Demographics, valproic acid treatment, posology and associated drug treatment, monitoring safety parameters, interactions and valproic acid concentrations.
Valproic acid is prescribed in 1 of 3 patients of the center. It was used in the approved indications in 8 (15%) of the 53 patients analyzed: 5 (9%) of them with bipolar disorder and 3 (6%) diagnosed with epilepsy. Other 5 patients (9%) were included in the extended schizoaffective disorder indication. 76% (40) of the evaluated patients were prescribed valproic acid off-label. The mean dose of valproic acid was 1.26 Defined Daily Dose / patient / day. An average of 6 drugs associated with valproic acid was found. 18% of patients had thrombocytopenia.
Valproic acid is often used off-label in psychiatric patients. It should be assessed the benefit-risk in this population.
丙戊酸常用于精神病学领域治疗精神分裂症及其他适应证以外的病症（“超适应证用药”）。然而，其有效性尚未得到充分证实，且使用时并非没有不良反应。本研究的主要目的是确定丙戊酸在已批准适应证中的使用频率以及在精神病患者中的“超适应证用药”情况。
设计了一项于2014年7月7日进行的横断面研究，样本为一家精神病中心的167名住院患者。收集人口统计学信息、丙戊酸治疗情况、剂量、相关药物治疗、安全参数监测、相互作用以及丙戊酸浓度。
该中心每3名患者中就有1人使用丙戊酸。在分析的53名患者中，8名（15%）用于已批准的适应证：其中5名（9%）患有双相情感障碍，3名（6%）被诊断为癫痫。另外5名患者（9%）纳入了精神分裂症后抑郁的扩展适应证。76%（40名）接受评估的患者使用丙戊酸属于超适应证用药。丙戊酸的平均剂量为1.26限定日剂量/患者/天。平均发现与丙戊酸联用6种药物。18%的患者出现血小板减少症。
丙戊酸在精神病患者中常被超适应证使用。应对该人群的获益风险进行评估。
