Department of Clinical Pharmacy and Pharmacology, RAK College of Pharmacy, RAK Medical and Health Sciences University.
Department of Psychiatry, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates.
Pharmazie. 2024 May 15;79(3):82-90. doi: 10.1691/ph.2024.3663.
Prescription patterns of antidepressants have changed over the years with a shift towards newer antidepressants with better tolerability and safety. Polypharmacy is common in psychiatry settings. The study aimed to evaluate the antidepressant drug prescription pattern and polypharmacy in a psychiatry outpatient setting. This prospective observational study was conducted in a psychiatric outpatient clinic. The medication use data of eligible patients were collected. In addition, the rationale of antidepressant medication prescription, the defined daily dosage (DDD), the prescribed daily dose (PDD), and the PDD to DDD ratio were assessed. The assessment of prescription polypharmacy was conducted utilizing the framework provided by the National Association of State Mental Health Program Directors. Data from 131 patients was analyzed. Major depressive disorder (32.8%) was the most common disorder for which antidepressants were prescribed. The majority, 91 (69.4%), received monotherapy. Selective serotonin reuptake inhibitors were the most frequently prescribed drugs in 69 (52.7%). Mirtazapine was the most frequently 32(24.4%) prescribed drug. Escitalopram and mirtazapine were the most commonly prescribed combination therapy (4.6%). Antipsychotic medications (37.4%) were the most widely co-prescribed medications, along with antidepressants. The PDD to DDD ratio was less than 1 for mirtazapine and imipramine; they were ≥1 for others. Psychiatric polypharmacy was documented in 87.1% of prescriptions. The total polypharmacy was not significantly (p>0.05) associated with demographic, illness, and treatment-related variables. Selective serotonin reuptake inhibitors were the most commonly prescribed antidepressants, monotherapy, and combination therapy. A substantial amount of patients received concomitant administration of antidepressants or psychotropic drugs, warranting careful monitoring.
抗抑郁药的处方模式多年来发生了变化，新的抗抑郁药具有更好的耐受性和安全性，因此使用这些药物的情况更为常见。精神科药物的联合应用较为常见。本研究旨在评估精神科门诊的抗抑郁药处方模式和联合用药情况。
这项前瞻性观察研究在精神科门诊进行。收集了合格患者的用药数据。此外，评估了抗抑郁药处方的理由、定义日剂量（DDD）、规定日剂量（PDD）和 PDD 与 DDD 的比值。采用国家精神卫生计划主任协会提供的框架评估处方联合用药情况。
分析了 131 名患者的数据。抗抑郁药最常被用于治疗的疾病是重度抑郁症（32.8%）。大多数患者（91 例，占 69.4%）接受单药治疗。选择性 5-羟色胺再摄取抑制剂（SSRIs）是最常开的药物，共 69 种（占 52.7%）。米氮平是最常开的药物（32 种，占 24.4%）。艾司西酞普兰和米氮平是最常用的联合治疗药物（各 4.6%）。抗精神病药物（37.4%）与抗抑郁药一起，是最广泛联合应用的药物。米氮平和丙咪嗪的 PDD 与 DDD 的比值小于 1；其他药物的比值大于 1。87.1%的处方存在精神科联合用药。总的联合用药情况与人口统计学、疾病和治疗相关变量无显著相关性（p>0.05）。SSRIs 是最常开的抗抑郁药，包括单药治疗和联合治疗。大量患者同时使用抗抑郁药或精神药物，需要密切监测。
