Department of Adult Psychiatry, Poznań University of Medical Sciences, Poznań, Poland.
Psychiatric Ward, "Zdroje" Hospital, Szczecin, Poland.
Pharmacol Rep. 2018 Aug;70(4):694-698. doi: 10.1016/j.pharep.2018.02.004. Epub 2018 Feb 5.
The concomitant use of two or more mood stabilisers (MS), second-generation antipsychotics (SGA), lamotrigine as well as antidepressants, is frequently reported in the treatment of bipolar patients The aim of this study was to investigate the pattern of pharmacological treatment with special regard to polypharmacy defined as two or more psychiatric drugs taken at the same time in the same patients with bipolar disorder discharged from psychiatric units in Poland.
Pharmacotherapy of 127 consecutive patients (57 females and 70 males) with an ICD-10 diagnosis of bipolar disorder (BP) at the point of discharge from five psychiatric regional hospitals/units in Poland, was evaluated in 2015/2016 on the basis of medical files. The effect of treatment on mental status at discharge was examined using the Clinical Global Impression-Improvement scale (CGI-I).
When only MS, SGA and lamotrigine, were taken into account, 78 (61%) of patients were prescribed two, 27 (21.3%) three and one patient four medications. The combination of MS and SGA was most commonly used (n=61, 48%). Medications preferred by Polish psychiatrists at patients' discharge were valproates (n=69, 54%), olanzapine (n=48, 37%), quetiapine (n=47, 37%) and lamotrigine (n=33, 25.9%). Thirty patients (23.6%) were prescribed lithium. No relationships were found between polypharmacy and patients' age, duration of illness and the rate of CGI-I. However, polypharmacy was significantly associated with types of bipolar disorder, particularly with the bipolar I disorder.
The prevalence of polypharmacy especially with MS and SGA in the treatment of bipolar patients discharged from psychiatric units in Poland is high. The most significant factor predisposing to polypharmacy is a diagnosis of bipolar - I disorder. In general, our study confirms trends observed in other countries.
在治疗双相情感障碍患者时，经常会同时使用两种或两种以上的心境稳定剂（MS）、第二代抗精神病药（SGA）、拉莫三嗪以及抗抑郁药。本研究旨在调查双相情感障碍患者出院时的药物治疗模式，特别关注同时服用两种或两种以上精神药物的联合用药情况，这些患者均从波兰的五家精神病区/单元出院。
2015-2016 年，基于病历，评估了波兰五家精神病区/单元的 127 例连续双相情感障碍（BP）患者（57 名女性和 70 名男性）的药物治疗。使用临床总体印象改善量表（CGI-I）评估出院时治疗对精神状态的影响。
仅考虑 MS、SGA 和拉莫三嗪时，78 例（61%）患者服用两种药物，27 例（21.3%）患者服用三种药物，1 例患者服用四种药物。MS 和 SGA 的联合使用最为常见（n=61，48%）。波兰精神科医生在患者出院时首选的药物是丙戊酸盐（n=69，54%）、奥氮平（n=48，37%）、喹硫平（n=47，37%）和拉莫三嗪（n=33，25.9%）。30 例（23.6%）患者服用锂盐。联合用药与患者年龄、疾病持续时间和 CGI-I 评分无相关性。然而，联合用药与双相障碍类型显著相关，尤其是与双相 I 型障碍相关。
在波兰的精神病区/单元出院的双相情感障碍患者中，联合用药（尤其是 MS 和 SGA）的比例很高。导致联合用药的最重要因素是双相 I 型障碍的诊断。总的来说，我们的研究证实了在其他国家观察到的趋势。
