河南省心理咨询中心抗抑郁药的用药趋势分折及预测

目的探讨河南省心理咨询中心抗抑郁药的应用状况及发展趋势.方法统计河南省心理咨询中心2003年6月25日～2004年6月24日处方数量、药品种类,计算构成比并排序.结果共收集处方2 051张.抗抑郁药处方1 881张,其中使用频率占前10位的药物依次为氟西汀(含进口和国产品)、马普替林、氯丙咪嗪,氟伏沙明,舍曲林、米氮平,曲唑酮、阿米替林、西酞普兰、万拉法辛(含进口和国产品).三环类药物占21.8%,去甲肾上腺素再摄取抑制剂占23.8%,5-羟色胺再摄取抑制剂占51.5%,其他新型抗抑郁药占15.9%.抗抑郁药治疗患者中,88.9%的病人接受单一药物治疗,合并治疗药物主要是苯二氮卓类药(51.9%),心境稳定剂(41.5%),抗精神病药(16.7%).结论新型抗抑郁药在抑郁障碍治疗中逐渐占主流,选择性作用位点药物的开发,应用前景乐观.     

上海某社区274例老年失眠患者安眠药物使用情况调查

目的了解上海市江甫社区门诊失眠患者助眠药物的使用现状及合理性。方法对2013年3月-2014年2月社区门诊274例失眠患者进行回顾性调查分析。结果助眠药物连续使用率为45.6%,连续使用10年以下者占31.4%,连续使用10年以上者占23.0%社区门诊失眠患者中苯二氮卓类药物助眠治疗的使用率为85.8%,中成药的使用率为14.2%,二者均使用者占5.5%。结论社区门诊失眠患者助眠药物的使用率较高,以使用苯二氮卓类药物为主,社区门诊患者在助眠药物的使用上存在不合理,需要引起社区医生的重视。     

上海市宝山区部分社区卫生门诊镇静催眠药物使用情况调查

目的 调查2018—2022年宝山区连续5年镇静催眠药物的使用情况。方法 从上海市宝山区18个社区卫生服务中心中随机抽取6个,调查门诊连续5年镇静催眠药物的使用情况。结果 6个社区卫生服务中心苯二氮卓受体激动剂药物储备差异较大,只有1个社区在2022年开设失眠门诊后,在临床中使用右佐匹克隆、唑吡坦。6个社区卫生服务中心苯二氮卓类药物处方量占比均高,其中1个社区卫生服务中心无非苯二氮卓类药物储备。5个社区卫生服务中心艾司唑仑的处方量较大,其余依次为：阿普唑仑、氯硝西泮、地西泮。结论 上海市宝山区整体上社区镇静催眠药种类储备不足,苯二氮卓类药物临床应用广泛,非苯二氮卓类药物处方量占比较低。应调整政策,培训医生,扩大宣传,从而促进镇静催眠类药物合理使用。     

河南省心理咨询中心抗抑郁药的用药趋势分析及预测

目的探讨河南省心理咨询中心抗抑郁药的应用状况及发展趋势。方法统计河南省心理咨询中心2003年6月25日～2004年6月24日处方数量、药品种类，计算构成比并排序。结果共收集处方2051张。抗抑郁药处方1881张，其中使用频率占前10位的药物依次为氟西汀(含进口和国产品)、马普替林、氯丙咪嗪，氟伏沙明，舍曲林、米氮平，曲唑酮、阿米替林、西酞普兰、万拉法辛(含进口和国产品)。三环类药物占21．8％，去甲肾上腺素再摄取抑制剂占23．8％，5-羟色胺再摄取抑制剂占51．5％，其他新型抗抑郁药占15．9％。抗抑郁药治疗患者中，88．9％的病人接受单一药物治疗，合并治疗药物主要是苯二氮卓类药(51．9％)，心境稳定剂(41．5％)，抗精神病药(16．7％)。结论新型抗抑郁药在抑郁障碍治疗中逐渐占主流，选择性作用位点药物的开发，应用前景乐观。     

滥用新型安眠药可致残

正安眠药以巴比妥类为第一代,苯二氮艹卓受体激动剂类为第二代,非苯二氮艹卓类受体激动剂等新型安眠药物为第三代。由于苯二氮艹卓类药物不良反应较多,现在越来越多的新型镇静催眠药物被批准用于临床,其主要种类有唑吡坦、佐匹克隆、右佐匹克隆、扎来普隆、雷美替胺、阿戈美拉汀、特斯美尔通等。右佐匹克隆、扎来普隆、唑吡坦     

精神病住院患者964 例精神药物时点调查

目的探讨住院患者精神药物的应用情况及其用药规律。方法选取2012年8月3日河南省精神病医院住院精神疾病患者的精神药物用药资料进行分析,并总结用药规律。结果抗精神病药物的用药频度居前5位的依次为喹硫平（22．72％）、利培酮（22．51％）、奥氮平（21．47％）、氯氮平（18．26％）、阿立哌唑（7．88％）。抗抑郁药用药频度居前3位的为：帕罗西汀（7．99％）、舍曲林和米氮平（均4．98％）、氟西汀（2．59％）。单一精神药物治疗（25．31％）和两种精神药物联用治疗（30．08％）占主导地位,占所有患者用药的55．39％;苯二氮卓类药物是临床常用的合用药物,精神药物使用基本合理。结论新型精神药物是目前精神药物使用的主流,且趋于多样性,人性化服务和改善用药的经济性有待进一步研究。     

浅谈失眠的药物治疗

正目前临床治疗失眠的药物,主要包括苯二氮艹卓类受体激动剂(BZRAs)、褪黑素受体激动剂、食欲素受体拮抗剂和具有催眠效应的抗抑郁药物。药物种类的选择非苯二氮艹卓类药物(non-BZDs)唑吡坦、右佐匹克隆和佐匹克隆属于快速起效的催眠药物,能够诱导睡眠始发,治疗入睡困难和睡眠维持障碍。扎来普隆的半衰期较短,仅适用于     

安眠药解读

<正>失眠是一个常见症状,几乎90%以上的成年人都有过失眠的体验,多数失眠患者需要在医生的指导下正确使用安眠药。目前安眠药大致分为苯二氮(艹卓)类(BDZ)、非苯二氮(艹卓)类、有镇静作用的抗抑郁和抗精神病药物、其他类。美国FDA批准治疗失眠的药物主要是苯二氮(艹卓)类和选择性MT受体激动剂。目前使用最多的是以地西泮为代表的苯二氮(艹卓)类和以唑吡坦为代表的非苯二     

门诊抗高血压药使用情况分析

目的了解我院门诊抗高血压药的使用情况。方法查阅我院2010年7月12日～7月18日门诊抗高血压药处方,统计分析患者的年龄、性别、抗高血压药的用药频度(DDDS)及药物的联合用药情况。结果排在用药频度前三位的类别是钙拮抗剂、β受体阻滞剂和血管紧张素Ⅱ受体拮抗剂,单一用药比例为58.81%,联合用药占41.19%,其中二联用药占联合用药的71.47%。结论我院门诊抗高血压药在品种选择,联合用药方案基本合理。     

孩子斜视改邪归正当乘早

目的:探讨失眠症的认知行为治疗.方法:选择长期服用苯二氮卓类药物(BZD)的失眠症患者60例,随机分为药物组和结合组(药物治疗+认知行为治疗),治疗前后均进行PSQI评分并比较两组的疗效.结果:治疗结束后结合组PSQI各因子分显著降低,且临床有效率明显优于药物组,结合组催眠药物用量明显小于药物组.结论:认知行为治疗(CBT)可以提高患者的心理健康水平和改善其睡眠质量,显效率明显优于药物组;可以帮助患者减少催眠药物的使用.     

Antidepressants Are the Most Commonly Discontinued Psychotherapeutic Medications in Pregnancy

BackgroundPsychiatric illnesses are common during the perinatal period. The use of antipsychotic medication during pregnancy has increased over the past two decades. In many instances, clinicians agree that untreated psychiatric illness during the perinatal period is more dangerous than the risks imposed by continuing psychotherapeutic medication. We describe patterns of psychotherapeutic medication continuation and discontinuation during pregnancy in a large U.S. cohort.MethodsWe assessed the relationship between the demographic and clinical characteristics of women who continued or discontinued psychotherapeutic medications—antidepressants, anxiolytics/sedatives, anticonvulsants, antipsychotics, mood stabilizers, and stimulants—during pregnancy. This study used data from 2008 to 2015 from the Medical Expenditure Panel Survey. We used t tests and Medical Expenditure Panel Survey Household Component longitudinal sampling weights in the analysis of this data.ResultsThere were few significant differences noted in clinical and demographic characteristics between women who continued and discontinued medications during pregnancy. Those who continued were less likely to be employed (46.95% of continuers were employed vs. 80.55% of discontinuers; p = .0053). Women taking antipsychotics were more likely to continue medications during pregnancy (64.60% continually used antipsychotics vs. 35.40% discontinued antipsychotics; p = .008), whereas women taking antidepressants were more likely to discontinue their use (19.62% continually used antidepressants vs. 80.38% discontinued antidepressants; p = .032). For each medication category, women resumed medication after pregnancy.ConclusionsAntidepressants are the most commonly discontinued psychotherapeutic medication during pregnancy. We recommend further research examining factors that may influence this observed difference.     

Clinically relevant drug interactions in the elderly

About 15% of hospital admissions of elderly patients in the Netherlands are caused by adverse effects of drugs. With polypharmacy there is an increased chance of adverse effects occurring. It is not always possible to reduce polypharmacy in the elderly. Polypharmacy is often associated with drug interactions which result in an increased or decreased effect, or the occurrence of adverse effects. Due to changes in the pharmacokinetic and pharmacodynamic properties of drugs in the elderly, the effect of interactions is more clinically relevant. Pharmacokinetic interactions influence absorption, liver metabolism or excretion by the kidneys. In particular, interactions with drugs that have a narrow pharmacotherapeutic spectrum can result in serious adverse effects: anticonvulsives, anti-Parkinson drugs, antipsychotics, coumarin derivates, digitalis preparations, lithium salts, opiates, sulphonylurea derivates, tricyclic antidepressants and verapamil. The most important pharmacodynamic changes in the elderly concern an increased sensitivity of the target organ. This is particularly the case for substances which have an effect on the central nervous system, such as antidepressants and antipsychotics, but also applies to benzodiazepines, coumarin derivatives and digoxin. When an unexpected adverse effect occurs in a patient or a previously effective therapy suddenly fails, it is wise to consider drug interaction as a possible cause.     

本院老年患者用药的合理性分析

目的对医院老年门诊患者处方的用药情况进行分析,对处方用药合理性进行分析探讨。方法收集2018年1月—2018年12月医院老年患者门诊处方1500张,对老年患者处方不合理用药情况进行归纳总结。结果1500张处方中,245张处方存在用药不合理现象,占16.33%,其中以用法用量不合理占比最高,为24.49%(60/245),其次为用药时机、疗程不合理,占17.14%(42/245);在不合理用药种类方面,抗菌药物及心血管系统药物占比最高,分别为53.06%(130/245)、16.33%(40/245)。结论我院老年门诊患者处方中存在不合理用药现象,以用法用量不合理、用药时机、疗程不合理最为突出,抗菌药物不合理应用占比高,应加强临床指导,提升老年患者用药合理性。     

Psychiatric medications for childbearing women

This paper assesses the use of psychiatric medications in childbearing women who are displaying acute symptoms of a moderate-to-severe mental illness. Childbearing may affect the course of illness and alterations in treatment are often required. In particular, the paper discusses the use of psychotropic drugs (including lithium, anti-epileptic drugs, antipsychotics, antidepressants, hormone treatment and electroconvulsive therapy) and their subsequent effects on the neonate, breastfeeding, development and teratogenicity. Since approximately 7% of women of childbearing age suffer from the acute symptoms of a moderate-to-severe mental illness, or have recently had an episode requiring drug treatment, a number of important problems need to be considered in the management of those episodes.