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阿卜杜勒阿齐兹国王医疗城痴呆症患者使用非典型抗精神病药物、抗抑郁药物和苯二氮䓬类药物的情况

The Prevalence of Atypical Antipsychotics, Antidepressants, and Benzodiazepines Use in Dementia Patients in King Abdulaziz Medical City.

作者信息

Basaeed Amani J, Wafia Gada, Alhidri Bashair, Sindi Layla A, Hakami Alqassem Y, Jastaniah Nisreen

机构信息

Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU.

Family Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU.

出版信息

Cureus. 2022 Oct 19;14(10):e30460. doi: 10.7759/cureus.30460. eCollection 2022 Oct.

Abstract

Background Dementia is a major neuropsychiatric disease defined by a progressive decline in cognitive functions. Atypical antipsychotics, antidepressants, and benzodiazepines are mainly prescribed for dementia. Many dementia pharmacological management options are associated with serious health risks. Therefore, this study aimed to determine the prevalence of antipsychotic, antidepressant, and benzodiazepine use in dementia patients in King Abdulaziz Medical City. Methodology A cross-sectional study was conducted at a tertiary hospital (King Abdulaziz Medical City, Jeddah) between December 2016 and January 2019. The participants were patients over the age of 65 years diagnosed with dementia. Data were collected from the medical records of the hospital after acquiring ethical approval. Patients with psychiatric diseases preceding the diagnosis of dementia, or patients with dementia-like symptoms as a side effect of any medications were excluded. The variables included were demographics, dementia subtypes, medications, and the presence or absence of chronic diseases. Results This study included 139 patients of whom 51.1% were males. The mean age was 82.8 ± 8.8 years. Moreover, 34.53% of the patients were prescribed medications for dementia management. Importantly, medications prescribed for dementia were classified as the following: atypical antipsychotics (20.86%), antidepressants (17.3%), and benzodiazepines (5%). The most commonly prescribed atypical antipsychotics were quetiapine (93.1%), risperidone (13.8%), and olanzapine (3.44%). For antidepressants, the most commonly prescribed medications for dementia were mirtazapine (62.5%), citalopram (45.8%), amitriptyline (8.3%), and paroxetine (4.2%). Moreover, most prescriptions for benzodiazepine were divided between lorazepam (71.4%), clonazepam (14.3%), and diazepam (14.3%). Conclusions This study's results were consistent with previous epidemiological studies that have been conducted worldwide regarding the increase in the use of antipsychotics and antidepressants, with the exception of benzodiazepines. To our knowledge, there is a lack of research regarding the medications prescribed in the geriatrics age group with dementia. Therefore, the outcomes of this study recommend initiating awareness campaigns among physicians, regarding the harm of using antipsychotics, especially for this age group. Lastly, future studies should focus on increased surveillance and evaluation of drug safety warnings in dementia patients to improve the outcomes of the intervention.

摘要

背景

痴呆症是一种主要的神经精神疾病,其定义为认知功能的进行性衰退。非典型抗精神病药物、抗抑郁药物和苯二氮䓬类药物主要用于治疗痴呆症。许多痴呆症的药物治疗方案都伴有严重的健康风险。因此,本研究旨在确定阿卜杜勒阿齐兹国王医疗城痴呆症患者中使用抗精神病药物、抗抑郁药物和苯二氮䓬类药物的患病率。

方法

2016年12月至2019年1月在一家三级医院(吉达阿卜杜勒阿齐兹国王医疗城)进行了一项横断面研究。参与者为65岁以上被诊断为痴呆症的患者。在获得伦理批准后,从医院的病历中收集数据。排除在痴呆症诊断之前患有精神疾病的患者,或因任何药物副作用出现痴呆样症状的患者。纳入的变量包括人口统计学、痴呆症亚型、药物以及慢性病的有无。

结果

本研究纳入了139名患者,其中51.1%为男性。平均年龄为82.8±8.8岁。此外,34.53%的患者接受了痴呆症治疗药物。重要的是,用于治疗痴呆症的药物分类如下:非典型抗精神病药物(20.86%)、抗抑郁药物(17.3%)和苯二氮䓬类药物(5%)。最常开具的非典型抗精神病药物为喹硫平(93.1%)、利培酮(13.8%)和奥氮平(3.44%)。对于抗抑郁药物,治疗痴呆症最常开具的药物为米氮平(62.5%)、西酞普兰(45.8%)、阿米替林(8.3%)和帕罗西汀(4.2%)。此外,大多数苯二氮䓬类药物的处方分布在劳拉西泮(71.4%)、氯硝西泮(14.3%)和地西泮(14.3%)之间。

结论

本研究结果与此前在全球范围内进行的关于抗精神病药物和抗抑郁药物使用增加的流行病学研究一致,但苯二氮䓬类药物除外。据我们所知,缺乏关于老年痴呆症患者所开药物的研究。因此,本研究结果建议在医生中开展宣传活动,告知使用抗精神病药物的危害,尤其是针对该年龄组。最后,未来的研究应侧重于加强对痴呆症患者药物安全警告的监测和评估,以改善干预效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b966/9673055/6cb046735741/cureus-0014-00000030460-i01.jpg

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