Schmidt L G, Czerlinsky H, Stöckel M
Int J Clin Pharmacol Ther Toxicol. 1987 May;25(5):244-50.
Psychotropic drug surveys serve to provide retrospective control of actual treatment conditions in psychiatric hospitals. Data of overall drug consumptions and those indicating the time pattern of medication were recorded at 7 census days for 1,415 inpatients of the psychiatric hospital of the Free University of Berlin. Drug-treated patients with 3.15 different psychotropic drugs on average during their stay. Neuroleptics were the most chosen compound group with regard to all patients treated (62.2%), the number of prescriptions (48.3%) and the sum of psychotropic days (57.9%). Sedatives (i.e. benzodiazepines and chloralhydrate) were given to more patients than antidepressants (41.0% vs. 29.3%), but accounted for only 5.7% of all psychotropic drug days (21.4% in case of antidepressants). The analysis of time pattern revealed that the prescription of neuroleptics was favoured on all census days, while prescribing for antiparkinsonian and lithium drugs increased also over time, but not for sedatives. Mean daily doses of most neuroleptics peaked near the 10th day after the patients' admission, while those of antidepressants increased steadily until the patients were discharged. Monotherapy was found in 59.0%, drug combinations in 41.0% of prescriptions (on all census days). The proportion of drug combinations in relation to monotherapy increased the longer the patients were in hospital. Among all drug combinations, two drugs had been combined in 79.2%, three or more in 20.8%. Two or more neuroleptics given simultaneously were involved in 44.9% of all combinations--an unexpected finding calling for more systematic investigation.
精神药物调查有助于对精神病医院的实际治疗情况进行回顾性对照。在7个普查日记录了柏林自由大学精神病医院1415名住院患者的总体药物消耗数据以及表明用药时间模式的数据。接受药物治疗的患者住院期间平均使用3.15种不同的精神药物。就所有接受治疗的患者而言，抗精神病药物是最常选用的药物类别（62.2%），在处方数量方面（48.3%）以及精神药物使用天数总和方面（57.9%）也是如此。使用镇静剂（即苯二氮䓬类和水合氯醛）的患者比使用抗抑郁药的患者更多（41.0%对29.3%），但镇静剂仅占所有精神药物使用天数的5.7%（抗抑郁药为21.4%）。时间模式分析显示，在所有普查日抗精神病药物的处方量都较大，而抗帕金森病药物和锂盐药物的处方量也随时间增加，但镇静剂并非如此。大多数抗精神病药物的日均剂量在患者入院后第10天左右达到峰值，而抗抑郁药的日均剂量则在患者出院前稳步增加。59.0%的处方为单一疗法，41.0%为药物联合疗法（在所有普查日）。患者住院时间越长，药物联合疗法相对于单一疗法的比例就越高。在所有药物联合疗法中，两种药物联合使用的占79.2%，三种或更多种药物联合使用的占20.8%。所有联合疗法中有44.9%涉及同时使用两种或更多种抗精神病药物——这一意外发现需要更系统的研究。
