Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Germany.
Psychiatric Private Hospital, Sanatorium Kilchberg, Zurich, Switzerland.
Pharmacopsychiatry. 2024 Nov;57(6):296-303. doi: 10.1055/a-2374-2386. Epub 2024 Aug 22.
Pharmacoepidemiological data suggest that lithium prescriptions for bipolar disorder are gradually decreasing, with less attention having been paid to other indications.
We examined lithium prescriptions between 1994 and 2017 in data provided by the Drug Safety in Psychiatry Program AMSP, including psychiatric hospitals in Germany, Austria and Switzerland. We compared lithium use for different diagnoses before and after 2001 and in three periods (T1: 1994-2001, T2: 2002-2009, and T3: 2010-2017).
In a total of 158,384 adult inpatients (54% female, mean age 47.4±17.0 years), we observed a statistically significant decrease in lithium prescriptions between 1994-2000 and 2001-2017 in patients with schizophrenia spectrum disorder from 7.7% to 5.1% and in patients with affective disorders from 16.8% to 9.6%. Decreases in use were also observed for diagnostic subgroups: schizoaffective disorder (ICD-10 F25: 27.8% to 17.4%), bipolar disorder (F31: 41.3% to 31%), depressive episode (F32: 8.1% to 3.4%), recurrent depression (F33: 17.9% to 7.5%, all: p<0.001) and emotionally unstable (borderline) personality disorder (6.3% to 3.9%, p=0.01). The results in T1 vs. T2 vs. T3 were for F25: 26.7% vs. 18.2% vs. 16.2%, F32: 7.7% vs. 4.2% vs. 2.7%, F33: 17.2% vs. 8.6% vs. 6.6% and for F31: 40.8% vs. 31.7% vs 30.0%, i. e. there was no further decrease for lithium use in bipolar disorder after 2002. Lithium's main psychotropic co-medications were quetiapine (21.1%), lorazepam (20.6%), and olanzapine (15.2%).
In inpatients, the use of lithium has decreased in patients with bipolar disorder and also with various other psychiatric diagnoses.
药物流行病学数据表明，锂在双相情感障碍中的处方量逐渐减少，而对其他适应证的关注则较少。
我们在德国、奥地利和瑞士的精神病院的药物安全在精神病学计划 AMSP 提供的数据中，检查了 1994 年至 2017 年间的锂处方。我们比较了 2001 年前和后以及三个时期（T1：1994-2001，T2：2002-2009 和 T3：2010-2017）锂在不同诊断中的使用情况。
在 158384 名成年住院患者（54%为女性，平均年龄 47.4±17.0 岁）中，我们观察到精神分裂症谱系障碍患者的锂处方从 1994-2000 年的 7.7%降至 2001-2017 年的 5.1%，情感障碍患者从 16.8%降至 9.6%。使用减少也见于诊断亚组：分裂情感障碍（ICD-10 F25：27.8%至 17.4%）、双相情感障碍（F31：41.3%至 31%）、抑郁发作（F32：8.1%至 3.4%）、复发性抑郁（F33：17.9%至 7.5%，均 p<0.001）和情绪不稳定（边缘性）人格障碍（6.3%至 3.9%，p=0.01）。T1 与 T2 与 T3 的结果为 F25：26.7%与 18.2%与 16.2%，F32：7.7%与 4.2%与 2.7%，F33：17.2%与 8.6%与 6.6%和 F31：40.8%与 31.7%与 30.0%，即双相情感障碍患者的锂使用在 2002 年后没有进一步减少。锂的主要精神科合并用药为喹硫平（21.1%）、劳拉西泮（20.6%）和奥氮平（15.2%）。
在住院患者中，锂在双相情感障碍患者和其他各种精神诊断中的使用减少。
