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门诊环境中精神障碍患者的药物不良事件

Adverse Drug Events in Patients with Mental Disorder in an Ambulatory Setting.

作者信息

Kumar Naveen, Sharma Sangeeta, Kapoor Vinod

机构信息

Department of Pharmacology, Faculty of Medicine and Health Sciences, SGT University, Gurgaon, Haryana, India.

Department of Neuropsychopharmacology, Institute of Human Behaviour and Allied Sciences, New Delhi, India.

出版信息

Int J Appl Basic Med Res. 2017 Apr-Jun;7(2):108-111. doi: 10.4103/2229-516X.205822.

Abstract

BACKGROUND

Although adverse drug events (ADEs) among inpatients occur frequently and are widely studied, few data are available on ADEs among outpatients with mental disorders.

AIMS

To determine the rates, types, and severity of ADEs in patients with mental disorder.

MATERIALS AND METHODS

Cross-sectional survey of patients with mental disorder attending outpatient department. Data were collected over a period of 6 months.

RESULTS

A total of 400 patients (217 schizophrenia patients, 127 bipolar affective disorder patients, and 56 patients of depression) with a mean age of 32.1 ± 9.7(±standard deviation) participated in the study. Patients suffering from schizophrenia and all nonadherent patients reported significantly more ADEs ( < 0.05). Out of 343 patients (86%) who reported at least one ADE, majority (87%) reported central nervous system ADEs followed by weight gain (48%), gastro-intestinal (28%), skin (4%), cardiovascular (1%), and sexual dysfunctions (0.3%). Out of 673 ADEs reported, sedation (41%) and weight gain (25%) were reported most commonly. Most ADEs reported (76%) were mild; however, there were no life-threatening, fatal, or serious ADEs. The medication classes most frequently involved in ADEs were antipsychotics (72%) followed by sedatives (44%), antimanic drugs (32%), and antidepressants (27%). Patients on atypical antipsychotic drugs reported significantly more body weight gain ( < 0.05). More than three drugs were prescribed in 49% of patients who reported ADEs.

CONCLUSION

The study data indicate high prevalence of ADEs in the outpatients on psychotropic medications.

摘要

背景

尽管住院患者中的药物不良事件(ADEs)频繁发生且已得到广泛研究,但关于患有精神障碍的门诊患者发生ADEs的数据却很少。

目的

确定精神障碍患者中ADEs的发生率、类型和严重程度。

材料与方法

对到门诊就诊的精神障碍患者进行横断面调查。数据收集期为6个月。

结果

共有400名患者(217名精神分裂症患者、127名双相情感障碍患者和56名抑郁症患者)参与了该研究,平均年龄为32.1±9.7(±标准差)。患有精神分裂症的患者和所有未遵医嘱服药的患者报告的ADEs明显更多(P<0.05)。在报告至少发生一次ADEs的343名患者(86%)中,大多数(87%)报告了中枢神经系统ADEs,其次是体重增加(48%)、胃肠道(28%)、皮肤(4%)、心血管(1%)和性功能障碍(0.3%)。在报告的673起ADEs中,镇静(41%)和体重增加(25%)最为常见。报告的大多数ADEs(76%)为轻度;然而,没有危及生命、致命或严重的ADEs。ADEs最常涉及的药物类别是抗精神病药物(72%),其次是镇静剂(44%)、抗躁狂药物(32%)和抗抑郁药物(27%)。服用非典型抗精神病药物的患者报告的体重增加明显更多(P<0.05)。在报告ADEs的患者中,49%的患者开具了三种以上的药物。

结论

研究数据表明,服用精神药物的门诊患者中ADEs的患病率很高。

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