Pathiyal A, Hylan T R, Jones J K, Davtian D, Sverdlov L, Keyser M
Degge Group, Ltd., Arlington, Virginia, USA.
Clin Ther. 1997 Jul-Aug;19(4):798-810. doi: 10.1016/s0149-2918(97)80103-8.
A study of the prescribing of anxiolytics and sedative-hypnotics and the occurrence of anxiety or sleep disorders before and after the initiation of selective serotonin reuptake inhibitor (SSRI) therapy may provide insight into differences in individual SSRIs. The purpose of our study was to evaluate whether and in what way the likelihood of being prescribed an anxiolytic or sedative-hypnotic or receiving a diagnosis of an anxiety or sleep disorder differed in patients prescribed either fluoxetine or paroxetine by a general practitioner (GP) in the Netherlands, where these two agents are the most commonly prescribed SSRIs. Episodes of SSRI treatment were constructed from a recently available GP database in the Netherlands. Logistic regression analysis was used to determine whether, after controlling for other observable factors, the receipt of paroxetine or fluoxetine was a statistically significant determinant for receipt of an anxiolytic or sedative-hypnotic or a diagnosis of an anxiety or sleep disorder. We found that patients who were prescribed fluoxetine as their index drug were less likely to receive a concomitant sedative-hypnotic on their index date compared with patients receiving paroxetine. After controlling for other observable factors, such as use of anxiolytics and sedative-hypnotics before SSRI therapy or on the index date or the existence of comorbid anxiety or sleep disorders, patients starting fluoxetine therapy were no more likely than patients starting paroxetine therapy to receive an anxiolytic or sedative-hypnotic or a diagnosis of an anxiety or sleep disorder during the 60-day post period. The likelihood of a patient's being diagnosed with or receiving a prescription for an anxiety or sleep disorder does not appear to be a differentiating factor between the prescribing of fluoxetine or paroxetine by GPs in the Netherlands.
一项关于在开始选择性5-羟色胺再摄取抑制剂（SSRI）治疗之前和之后抗焦虑药及镇静催眠药的处方情况以及焦虑或睡眠障碍的发生情况的研究，可能会为不同个体SSRI之间的差异提供见解。我们研究的目的是评估在荷兰，由全科医生（GP）开具氟西汀或帕罗西汀处方的患者中，开具抗焦虑药或镇静催眠药的可能性以及被诊断为焦虑或睡眠障碍的可能性是否存在差异，以及以何种方式存在差异，在荷兰这两种药物是最常开具的SSRI。SSRI治疗的发作情况是根据荷兰最近可用的全科医生数据库构建的。逻辑回归分析用于确定在控制其他可观察因素后，接受帕罗西汀或氟西汀是否是开具抗焦虑药或镇静催眠药或被诊断为焦虑或睡眠障碍的统计学显著决定因素。我们发现，与接受帕罗西汀的患者相比，以氟西汀作为索引药物开具处方的患者在索引日期接受联合镇静催眠药的可能性较小。在控制其他可观察因素后，例如在SSRI治疗之前或索引日期使用抗焦虑药和镇静催眠药或存在共病焦虑或睡眠障碍，开始氟西汀治疗的患者在60天后期接受抗焦虑药或镇静催眠药或被诊断为焦虑或睡眠障碍的可能性并不比开始帕罗西汀治疗的患者更高。在荷兰，全科医生开具氟西汀或帕罗西汀处方时，患者被诊断为焦虑或睡眠障碍或接受相关处方的可能性似乎不是一个区分因素。
