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德国一家精神病学大学医院的药物处方模式。

Drug prescribing pattern of a psychiatric university hospital in Germany.

作者信息

Schmidt L G, Niemeyer R, Müller-Oerlinghausen B

出版信息

Pharmacopsychiatria. 1983 Mar;16(2):35-42. doi: 10.1055/s-2007-1017445.

DOI:10.1055/s-2007-1017445
PMID:6867092
Abstract
  1. The drug treatment of 1,263 psychiatric patients (= 96% of all in-patients admitted during a period of 2 years) was analyzed by means of case histories. During hospitalization 7.4% of all patients were treated completely drug-free; 12.5% received no psychoactive drugs. 2. The patients were hospitalized for 50 days on the average, and received psychoactive drugs on 43 days. During the total treatment period, they were prescribed an average of 4.3 (median 3.8) different drugs; of these, 2.7 (median 2.3) were various psychoactive drugs. Neuroleptics were the most frequently used drugs; they were prescribed at least once during treatment for 62% of all patients. Antidepressants were prescribed for almost 30% of the patients. 3. For the neuroleptics prescriptions decreased with patient's age; they increased for the antidepressants. Antiparkinsonian agents were prescribed to 51% of neuroleptic-treated patients under 45 years of age, and to 26% of these patients over 45. 4. Neuroleptics were prescribed more frequently in male patients, antidepressants in female patients. 5. Among the individual prescriptions, perazine was the most favoured of the neuroleptics, and amitriptyline of the antidepressants. Clozapine was prescribed for the longest period among all psychotropic agents except lithium salts. Antiparkinsonian agents were used for shorter periods than the neuroleptics administered simultaneously. One-fifth of the patients were given analgesics for brief periods. 6. Medication pattern is related to specific nosology. 95% of schizophrenic patients received neuroleptics for at least an average of 41 days; every second patient in this group received antiparkinsonian agents. 90% of unipolar depressed patients were given antidepressants; during one course of treatment at least 2 different antipressant drugs were prescribed for 32% of these patients. 43% of unipolar depressed patients received neuroleptics for an average of 33 days. Lithium salts were administered for an average of 45 days to 43% of the patients with affective disorders. 7. Treatment surveys of this kind supplement the collection of data on adverse drug reactions by drug monitoring systems. The relationship between the side effects of drugs and the prescription pattern of individual drugs allows one to determine the incidence rates of drug side effects.
摘要
  1. 通过病历分析了1263名精神科患者(占两年内所有住院患者的96%)的药物治疗情况。住院期间,7.4%的患者完全未使用药物治疗;12.5%的患者未使用精神活性药物。2. 患者平均住院50天,其中43天使用精神活性药物。在整个治疗期间,他们平均使用4.3种(中位数为3.8种)不同药物;其中2.7种(中位数为2.3种)为各类精神活性药物。抗精神病药物是最常用的药物;62%的患者在治疗期间至少使用过一次。近30%的患者使用过抗抑郁药。3. 抗精神病药物的处方量随患者年龄增加而减少;抗抑郁药的处方量则增加。45岁以下接受抗精神病药物治疗的患者中,51%使用了抗帕金森药物,45岁以上的此类患者中这一比例为26%。4. 男性患者使用抗精神病药物更为频繁,女性患者使用抗抑郁药更为频繁。5. 在各类药物处方中,奋乃静是最常用的抗精神病药物,阿米替林是最常用的抗抑郁药。除锂盐外,氯氮平在所有精神药物中的使用时间最长。抗帕金森药物的使用时间比同时使用的抗精神病药物短。五分之一的患者短期使用过镇痛药。6. 用药模式与特定的疾病分类相关。95%的精神分裂症患者至少平均使用抗精神病药物41天;该组中每两名患者就有一名使用抗帕金森药物。90%的单相抑郁症患者使用抗抑郁药;在一个疗程中,32%的此类患者至少使用过2种不同的抗抑郁药物。43%的单相抑郁症患者平均使用抗精神病药物33天。43%的情感障碍患者平均使用锂盐45天。7. 此类治疗调查补充了药物监测系统收集的药物不良反应数据。药物副作用与个别药物的处方模式之间的关系有助于确定药物副作用的发生率。

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引用本文的文献

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Prognosis of the course of schizophrenic psychoses compared to other psychiatric illnesses. Catamnestic treatment and outcome 1 year after discharge.与其他精神疾病相比,精神分裂症性精神病病程的预后。出院1年后的随访治疗及结果
Eur Arch Psychiatry Neurol Sci. 1984;234(3):189-97. doi: 10.1007/BF00461560.
2
Assessment of adverse drug reactions in psychiatric hospitals.精神病医院中药物不良反应的评估。
Eur J Clin Pharmacol. 1984;26(6):727-34. doi: 10.1007/BF00541933.
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Consistency of assessment of adverse drug reactions in psychiatric hospitals: a comparison of an algorithmic and an empirical approach.
精神病医院药物不良反应评估的一致性:算法方法与经验方法的比较
Eur J Clin Pharmacol. 1986;30(2):199-204. doi: 10.1007/BF00614303.