Simal-Aguado, Galindo-Tovar, Department of Pharmacy, Health Sciences Faculty, San Antonio Catholic University of Murcia, UCAM, Murcia; Spain. Campos-Navarro, Unit of Acute Psychiatry, Santa Lucia University Hospital, Cartagena; Spain. Valdivia-Muñoz, Center of Mental Health Infante, Murcia; Spain, Center of Mental Health Cartagena, Cartagena, Murcia; Spain. Garcia-Carmona, Department of Neurology, Santa Lucia University Hospital, Cartagena; Spain, Unit of Acute Psychiatry, Reina Sofia University Hospital, Murcia; Spain.
Psychopharmacol Bull. 2021 Jan 12;51(1):81-93.
we aimed 1) to evaluate the risk factors associated to the benzodiazepines intake; 2) to assess the impact about the use of long acting injectables antipsychotics (LAIs); 3) to assess the risk in severe and affective disorders and 4) to identify the prescription patterns of use in mental health in a cohort of patients from Spain.
735 outpatients from Mental Health were included. Demographic and clinical data were collected. In order to compare the use of benzodiazepines we calculated the daily dose equivalents (mg/day) to diazepam as standard.
The most commonly prescribed benzodiazepine was clonazepam (33%) and the mean daily dose of diazepam equivalents was 24.9 mg. It was higher in affective disorders (40.35 ± 3.36) and lower in patients using LAIs antipsychotics (17.50 ± 1.39; p = 0.001). Multivariate analysis showed that to be women (OR = 1.559, 95% CI = 1.059-2.295, p = 0.024), the use of drugs (OR = 1.671, 95% CI = 1.127-2.477, p = 0.011) and suffering any affective disorder (OR = 1.542, 95% CI = 1.355-1.826, p = 0.040) increased the risk of benzodiazepine intake. In contrast, the use of LAIs antipsychotics significantly reduced it versus oral antipsychotics (OR = 5.226, 95% CI = 3.185-8.575, p = 0.001).
benzodiazepines are widely prescribed, mainly clonazepam followed by lorazepam and diazepam. Most of patients used at least one benzodiazepine and the mean daily intake was 25 mg diazepam equivalents. Therefore, benzodiazepines are extensively prescribed and used at higher doses than desirable. These, findings could be useful for clinicians and their practice.
我们旨在 1)评估与苯二氮䓬类药物摄入相关的风险因素;2)评估长效注射抗精神病药物(LAIs)的使用影响;3)评估在严重和情感障碍中的风险;4)确定西班牙患者队列中精神卫生保健中使用的处方模式。
纳入了 735 名来自精神卫生保健的门诊患者。收集了人口统计学和临床数据。为了比较苯二氮䓬类药物的使用,我们计算了以地西泮为标准的等效日剂量(mg/天)。
最常开的苯二氮䓬类药物是氯硝西泮(33%),地西泮等效日剂量的平均值为 24.9mg。在情感障碍患者中更高(40.35±3.36),在使用 LAIs 抗精神病药物的患者中更低(17.50±1.39;p=0.001)。多变量分析显示,女性(OR=1.559,95%CI=1.059-2.295,p=0.024)、使用药物(OR=1.671,95%CI=1.127-2.477,p=0.011)和患有任何情感障碍(OR=1.542,95%CI=1.355-1.826,p=0.040)增加了苯二氮䓬类药物摄入的风险。相比之下,与口服抗精神病药物相比,使用 LAIs 抗精神病药物显著降低了风险(OR=5.226,95%CI=3.185-8.575,p=0.001)。
苯二氮䓬类药物广泛开处方,主要是氯硝西泮,其次是劳拉西泮和地西泮。大多数患者至少使用一种苯二氮䓬类药物,日平均摄入量为 25mg 地西泮等效物。因此,苯二氮䓬类药物广泛开处方且使用剂量高于理想剂量。这些发现可能对临床医生及其实践有用。