Peritogiannis Vaios, Manthopoulou Thiresia, Mavreas Venetsanos
Mobile Mental Health Unit of the Prefectures of Ioannina and Thesprotia, Society for the Promotion of Mental Health in Epirus, Ioannina, Greece.
Department of Psychiatry, University of Ioannina School of Medicine, Ioannina, Greece.
J Neurosci Rural Pract. 2016 Dec;7(Suppl 1):S26-S30. doi: 10.4103/0976-3147.196447.
Long-term benzodiazepine (BZD) treatment in patients with mental disorders is widespread in clinical practice, and this is also the case of patients with schizophrenia, although the evidence is weak and BZD prescription is discouraged by guidelines and medical authorities. Data on BZD prescription are usually derived from national or regional databases whereas information on the use of BZD by patients with schizophrenia and related psychoses in general population-based samples is limited.
Information for 77 patients with psychotic disorders who were regularly attending follow-up appointments with the multidisciplinary Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia, Northwest Greece, during 1-year period (2015) was obtained from our database.
From the total of 77 engaged patients, 30 (39%) were regularly prescribed BZDs in the long term, as part of their treatment regimen. Prescribed BZDs were mostly diazepam and lorazepam, in 43.3% of cases each. The mean daily dose of these compounds was 13 mg and 3.77 mg, respectively. Statistical analysis showed a correlation of long-term BZD use with the history of alcohol/substance abuse. Most patients were receiving BZD continuously for several years, and the mean dose was steady within this interval.
A large proportion of patients with psychotic disorders were regularly prescribed BZD in long term. It appears that when BZDs are prescribed for some period in the course of a psychotic disorder, their use commonly exceeds the recommended interval and then becomes a regular part of the chronic treatment regimen. Future research should address the factors that may be related to the long-term BZD use by patients with psychotic disorders. Interventions for the reduction of regular BZD prescription should target the primary care setting and all those who treat first episode patients.
在临床实践中，精神障碍患者长期使用苯二氮䓬类药物（BZD）的情况很普遍，精神分裂症患者也是如此，尽管证据不足，且指南和医学权威机构不鼓励开具BZD处方。BZD处方数据通常来自国家或地区数据库，而基于一般人群样本的精神分裂症及相关精神病患者使用BZD的信息有限。
从我们的数据库中获取了2015年期间在希腊西北部约阿尼纳州和塞斯普罗蒂亚州多学科移动心理健康单元定期接受随访的77例精神障碍患者的信息。
在77例参与研究的患者中，30例（39%）长期定期开具BZD作为其治疗方案的一部分。开具的BZD主要是地西泮和劳拉西泮，各占43.3%的病例。这些化合物的平均日剂量分别为13毫克和3.77毫克。统计分析表明，长期使用BZD与酒精/物质滥用史相关。大多数患者连续数年持续使用BZD，且在此期间平均剂量稳定。
很大一部分精神障碍患者长期定期开具BZD。似乎在精神障碍病程中开具BZD一段时间后，其使用通常会超过推荐的间隔时间，然后成为慢性治疗方案的常规组成部分。未来的研究应探讨可能与精神障碍患者长期使用BZD相关的因素。减少常规BZD处方的干预措施应针对基层医疗环境以及所有治疗首发患者的人员。
