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上市后监测中精神药物治疗的质量监测。吗氯贝胺药物利用观察(DUO)研究的结果。

Quality-monitoring of psychotropic drug therapy in post-marketing surveillance. Results of a drug utilization observation (DUO) study on moclobemide.

作者信息

Laux G, Baier D

机构信息

Department of Psychiatry and Psychotherapy, District Hospital Gabersee, Wasserburg/Inn.

出版信息

Pharmacopsychiatry. 1997 Jan;30(1 Suppl):21-7. doi: 10.1055/s-2007-979513.

DOI:10.1055/s-2007-979513
PMID:9035224
Abstract

Thanks to their non-intervening nature, post-marketing drug utilization observation (DUO) studies reflect both the properties of the substance under investigation and doctors' treatment decisions, thus-in contrast with clinical trials-allowing the interactions of these two factors to be investigated. A DUO study involving the administration of moclobemide to 9419 patients investigated the prescribing behavior of about two-thirds of all general practitioners and internists in Germany prescribing moclobemide during the study period. The results obtained suggest that, on the whole, moclobemide is being prescribed knowledgeably and correctly for the treatment of the full spectrum of depressive disorders. The management of these patients tended to adhere strictly to existing treatment recommendations while at the same time revealing a certain degree of latitude for treatment optimization. This applies particularly to the utilization of the recommended dosage range, especially in severely depressed states, and the consistent, syndrome-based combination treatment with hypnotics/sedatives or neuroleptics in the respective patient groups indicated. Potential interactions-though comparatively few are known for moclobemide-were taken into account in most cases. The safety profile closely matches the experience gained from clinical trials. Despite the large sample size involved there was no evidence of any hitherto unknown serious events. The experience gained during this survey suggests that the DUO study is a suitable instrument for monitoring the use of an antidepressant in the early post-registration period, enabling action to be taken at an early stage to correct any systematic deviations from the conditions of registration.

摘要

由于其非干预性特点,上市后药物利用观察(DUO)研究既反映了被研究药物的特性,也反映了医生的治疗决策,因此与临床试验不同,它能够对这两个因素的相互作用进行研究。一项针对9419名患者使用吗氯贝胺的DUO研究,调查了在研究期间德国约三分之二开具吗氯贝胺处方的全科医生和内科医生的处方行为。所获得的结果表明,总体而言,吗氯贝胺在用于治疗各种抑郁症时的处方开具是明智且正确的。这些患者的治疗管理倾向于严格遵循现有的治疗建议,同时也显示出在治疗优化方面有一定的灵活性。这尤其适用于推荐剂量范围的使用,特别是在重度抑郁状态下,以及在各自指定的患者群体中与催眠药/镇静药或抗精神病药进行基于综合征的持续联合治疗。在大多数情况下,都考虑到了潜在的相互作用——尽管已知吗氯贝胺的相互作用相对较少。安全性概况与临床试验获得的经验密切匹配。尽管涉及的样本量很大,但没有证据表明存在任何迄今未知的严重事件。本次调查获得的经验表明,DUO研究是监测抗抑郁药在注册后早期使用情况的合适工具,能够在早期采取行动纠正任何与注册条件的系统性偏差。

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