抑郁症患者的治疗用药分析

目的了解该院住院抑郁症患者精神药物的临床使用情况。方法使用一日法对该院2012年抑郁症住院患者的精神药物处方进行调查。结果药物治疗抑郁症的方案有13种,联用抗抑郁药、抗精神病药和心境稳定剂88例（72.73%）;使用的抗抑郁药均为新型抗抑郁药,其中舍曲林使用频率最高（29.75%）;使用抗精神病药94例（77.69%）,其中奥氮平使用频率最高（27.27%）;抗焦虑药以苯二氮卓艹卓为主,阿普唑仑与劳拉西泮共占59.50%（72/121）。结论该院抗抑郁药的使用能够做到个体化用药,治疗抑郁症方案合理、有效。     

老年精神障碍患者精神药物临床使用分析

目的:了解老年精神障碍患者精神药物临床使用情况。方法:收集肇庆市第三人民医院2008年1月1日-2008年12月31日出院,年龄60a或以上老年住院精神障碍患者的病历175份,采用限定日剂量(DDD)和药物利用指数(DUI)对精神药物的使用进行回顾性分析。结果:非典型抗精神病药利培酮的使用频率居首位,其次为奋乃静;抗抑郁药中舍曲林居首位,其次为帕罗西汀;在联合用药方面,抗精神病药与苯二氮艹卓类药物、抗抑郁药与苯二氮卓艹类药物和情感稳定剂、抗精神病药与抗抑郁药联用较多。在使用的33种精神药物中除舒必利、丙戊酸钠、阿普唑仑、三唑仑外,其余药物的DUI均≤1.0。结论:我院对老年精神障碍患者精神药物的使用基本合理。非典型抗精神病药、新型抗抑郁药的使用越来越多。     

精神病专科医院300例住院患者中应用苯二氮（艹卓）类药物情况分析

目的：探讨精神病专科医院住院患者应用苯二氮(艹卓)类药物的使用情况。方法：随机选取我院300例住院患者作为研究对象,通过住院精神病患者调查表分析住院精神病患者使用苯二氮(艹卓)类药物的整体情况。结果：我院精神病住院患者使用苯二氮(艹卓)类药物人数为110例、占比36.7%。药物共有4种,其中使用氯硝西洋的69例、占比62.7%;使用艾司唑仑的3例,占比2.7%;精神分裂症患者中使用苯二氮(艹卓)类药物83例,占比75.6%。结论：精神病专科医院住院患者应用苯二氮(艹卓)类药物能够起到一定作用,但不宜过度使用。     

门诊苯二氮（艹卓）类药物应用分析

目的 了解我院门诊苯二氮（艹卓）类药物（BZD）的使用情况,评价其合理性.方法 对我院2009年1月1日至12月31日使用苯二氮（艹卓）类药物的门诊处方共17 185张进行统计与分析.结果 苯二氮（艹卓）类药物广泛应用于精神科和心理科门诊,主要联合用药处方有苯二氮（艹卓）类与抗抑郁药7011张（40.80%）,苯二氮（艹卓）类与抗精神病药物6149张（35.78%）,不合理用药处方占所统计总处方数的1.32%.结论 苯二氮（艹卓）类药物在我院门诊的使用是基本合理的,但亦存在少数不合理用药现象,是造成苯二氮（艹卓）类药物滥用的主要原因.     

大连市县区级精神疾病患者药物治疗现况时点调查

目的:了解大连市县区级精神卫生专科机构住院患者的药物使用情况。方法:本调查采用一日法对大连市县区级精神专科医院(金州四院,瓦房店四院,庄河六院,普兰店四院)713例住院患者药物应用情况进行调查,对结果进行统计分析。结果:精神科用药以单一用药为主,其中大部分为国产新型抗精神病、抗抑郁药物,利培酮的使用占于首位;联用苯二氮卓类药物及对抗副反应药物较多,情感稳定剂以丙戊酸盐为主。结论:大连县区级精神专科机构精神科用药基本规范。     

首发抑郁症患者药物使用分析

收集厦门精神卫生中心2010年1月～2011年3月出院,首发住院抑郁症患者病历138份,采用限定日剂量(DDD)和药物利用指数(DUI)对精神药物的使用进行回顾性分析.结果抗抑郁药中西酞普兰使用居首位,其次为舍曲林、度洛西汀、氟西汀和文拉法辛;在联合用药方面,抗抑郁药与苯二氮艹卓类药物和小剂量抗精神病药物联用较多,占60%.在使用的药物中,DUI均≤1.0.     

我院精神病住院患者抗精神病药应用情况分析

目的:了解我院精神病住院患者抗精神病药的应用情况,为临床合理用药提供参考。方法:对我院2008年7月21日共770例精神病住院患者的用药情况进行调查。结果:有734例患者应用抗精神病药进行治疗,共涉及药物治疗方案30种;单用1种抗精神病药治疗者676例(87.8%),利培酮190例(24.7%)、喹硫平144例(18.7%)、奥氮平123例(16.0%)分列前3位;抗精神病药与抗抑郁药、心境稳定剂、苯二氮类药及非苯二氮类镇静催眠药、降糖药、调血脂药联用比例较高。结论:新型非典型抗精神病药已替代传统抗精神病药,其单一用药占临床治疗主导地位。     

住院精神疾病患者药物治疗情况分析

［摘要］目的了解住院精神疾病患者药物治疗现状。方法采用一日法,于2010年7月16日对杭州市第七人民医院住院精神疾病患者药物治疗情况进行调查,并与2009年同期比较。结果抗精神病药联用2种及以上有增加趋势,合用抗抑郁药、心境稳定药有增加趋势,苯二氮类药物使用合理,抗精神病药联用苯二氮类药物或（和）心境稳定药有利于精神病治疗。结论精神药物应用的多样性已是一种趋势。如何提高疗效、减少不良反应和提供人性化的服务,值得进一步研究。     

住院精神分裂症病人应用苯二氮(艹卓)类药物调查

目的了解苯二氮(艹卓)类药物(BZD)在精神分裂症患者中应用情况.方法对189例住院精神分裂症病人应用BZD情况进行回顾性调查.结果合并使用BZD者53例,占 28.04%,以应用氯硝安定为多.结论苯二氮(艹卓)类并用抗精神病药治疗精神分裂症使用率较高,在临床使用时应予注意,合理用药,防止滥用.     

首次与多次住院精神分裂症患者抗精神病药使用调查

目的:了解首次住院与多次住院精神分裂症患者的抗精神病药用药情况。方法:采用一日法,对我院首次与多次住院精神分裂症患者抗精神病药使用情况进行调查,并对两者的调查结果进行比较。结果:在药物使用种类上,首次与多次住院患者使用频率排前5位的均为非典型性抗精神病药,首次住院患者用药频率最高的是奥氮平,多次住院患者用药频率最高的是氯氮平;首次住院精神分裂症患者在单一用药及非典型抗精神病药物的使用率上明显高于多次住院患者,差异均有统计学意义(P<0.05);在合并苯海索片、心境稳定剂、抗抑郁药、苯二氮类药上,两者差异无统计学意义。结论:我院首次住院精神分裂症患者在单一用药及非典型抗精神病药物的使用率上均高于多次住院患者,氯氮平较少用于首次住院患者。     

精神科住院患者用药时点调查分析

目的：了解中山市第三人民医院住院精神障碍患者的药物应用情况及其用药规律。方法采用一日法,以2013年5月14日为时间节点,对住院患者的用药情况进行分析,总结其用药规律。结果住院患者抗精神病药用药频度居前5位的依次为利培酮、氯氮平、奥氮平、阿立哌唑和喹硫平。心境稳定剂用药频度居前3位的是丙戊酸钠、奥卡西平和丙戊酸镁。结论非典型抗精神病药和新型抗抑郁药已成为临床一线用药,临床治疗总体用药比较规范,但仍需要注意苯海索和苯二氮类（BDZ）的合理使用。     

Pharmacotherapy of mood disorders and psychosis in pre- and post-natal women

Introduction: Untreated mood and psychotic disorders can have substantial adverse impacts on the patient, the fetus and the family, while treatment can ameliorate such problems. To address concerns by clinicians about the risks of psychotropic medications, this review addresses the risk/benefit analysis of somatic therapies for psychiatric disorders during pregnancy and lactation.

Areas covered: All available research was reviewed on the impact on pregnancy and breastfeeding of mood and psychotic disorders, and of antidepressants, mood stabilizers, antipsychotic drugs, and electroconvulsive therapy. References cited in other reviews, case series, formal studies, pharmacologic discussions, and theoretical pieces were added. Available case control and other studies were critically reviewed and diverse explanations for their findings were considered.

Expert opinion: The potential benefits of treatment of mood and psychotic disorders often outweigh the risks after alternative therapies have been considered. Some medications, particularly paroxetine and valproate, pose greater risks during pregnancy, while the teratogenic risks of lithium have probably been overstated. There is more experience with first than with second generation antipsychotic drugs during pregnancy and lactation. Nursing an infant is possible while taking a number of antidepressants, mood stabilizers or antipsychotic drugs.     

河北省双相障碍患者药物治疗现状的调查分析

目的:为促进河北省双相障碍患者治疗的规范化、合理化,特别是为提高基层的临床治疗水平提供参考。方法:选取在河北省39家精神专科医院或综合医院精神科接受精神药物治疗的门诊或住院双相障碍患者,通过问卷调查患者的药物治疗情况,并对数据进行统计分析。结果:共发放问卷521份,回收有效问卷519份,有效回收率为99.6%。397例(76.5%)患者接受心境稳定剂治疗,使用频率排前3位的分别为丙戊酸钠、碳酸锂和丙戊酸镁;455例(87.7%)患者接受抗精神病药治疗,使用频率排前5位的分别为喹硫平、奥氮平、利培酮、氯氮平和阿立哌唑;89例(17.1%)患者接受抗抑郁药治疗,其中73.0%使用选择性5-羟色胺再摄取抑制剂;154例(29.7%)患者接受苯二氮类药物治疗,47例(9.1%)患者辅以抗胆碱药物治疗,27例(5.2%)患者辅以β受体阻滞药治疗。双相障碍治疗以联合用药为主,428例(82.5%)患者联合2种以上精神药物治疗,以心境稳定剂联合抗精神病药为主;且抗抑郁药使用以联合心境稳定剂或抗精神病药为主。住院患者心境稳定剂的使用与门诊患者比较,差异有统计学意义(P<0.01),丙戊酸钠的使用频率低于门诊患者,碳酸锂和丙戊酸镁的使用频率高于门诊患者;住院患者接受抗抑郁药治疗的比例显著低于门诊患者,二者比较差异有统计学意义(P<0.05)。结论:河北省双相障碍患者的治疗以心境稳定剂联合抗精神病药为主要的方式;抗精神病药的使用比例较高,以非典型抗精神病药为主;抗抑郁药的使用以联合用药为主;心境稳定剂在住院与门诊的选择有所不同,且抗抑郁药门诊使用比例较高。双相障碍患者的治疗总体符合双相障碍防治指南的推荐用药原则。     

The armamentarium of treatments for bipolar disorder: a review of the literature

To assess current pharmacotherapeutic options for bipolar disorder, with particular emphasis on the use of antipsychotic agents, Medline and EMBASE were searched between January 1980 and December 2005 using the keywords "schizoaffective disorder" and "bipolar disorder", combined with various antidepressants, antipsychotics, lithium or other mood stabilizers. English-language articles, review articles and original research articles were reviewed. Most data are available for the "mood stabilizers" lithium and valproate. However, these agents have important limitations regarding their tolerability and efficacy in certain groups. Newer anticonvulsants, especially lamotrigine, have demonstrated efficacy across mood-symptom domains. Antidepressants are not generally favoured as monotherapy in patients with bipolar depression or schizoaffective disorder, due to their potential to induce switching to manic states. However, data are emerging for the efficacy of selective serotonin reuptake inhibitors for bipolar depression in combination with atypical antipsychotics. Atypical antipsychotics may also be used as monotherapy or in conjunction with mood stabilizers for the treatment of acute mania and for continuing maintenance therapy. The choice of antipsychotic may be influenced by the therapeutic situation; formulations that facilitate administration in the acute scenario can provide rapid tranquillization, whereas those that enhance compliance may have a place in maintenance therapy. Our results suggest a growing role for atypical antipsychotics in the treatment of bipolar disorder and further data are anticipated.     

住院精神病人精神药物使用情况调查

目的 :了解精神病人用药现状 ,为临床用药提供一定依据。方法 :对某精神病医院 373例住院精神病人用药情况进行时点调查。结果 :使用频率最高的抗精神病药物依次为氯氮平、舒必利、利培酮、氟哌啶醇等 ,单用抗精神病药物 2 5 7例 (6 8 90 % ) ,合并用抗精神病药物 85例(2 2 8% )。结论 :住院精神病人以精神分裂症为主 ,最常用为非典型抗精神病药物 ,单一使用为主 ,其它典型抗精神病药物使用频率已下降     

Pregnant opioid addicted patients and additional drug intake. Part II: Comorbidity and their therapy

The majority of opioid dependent patients suffer from various psychiatric and somatic comorbid diseases like mood and anxiety disorders, psychotic diseases, personality disorders, HIV infection, Hepatitis B and C. If medical treatment is needed, grouping active substances to FDA Pregnancy Categories (A, B, C, D or X) may be helpful. The majority of substances reported here only fulfill the FDA-categories C or D, which means that they could have teratogenic effects, but with probably different rank order. First of all, referring to mood, personality and anxiety disorders, the focus should be laid on non-pharmacological treatment by offering psychotherapeutic and supporting psychosocial interventions to the patients. However, opioid dependent pregnant patients who suffer from severe diseases such as psychosis, bipolar affective disorder or severe depression, may need psychoactive medication like antipsychotics, antidepressants or mood stabilizers to prevent them from harm caused by psychotic ideas and actions and/or suicidality. However these medications may comprise fetal risks, especially when taken together, and therefore should only be used when benefit and risks are considered together with patients and their relatives. It is important to avoid acute or renewed psychiatric decompensation. We present the current differentiated knowledge for therapy of opioid dependent patients with antipsychotics, antidepressants (e.g. higher fetal risk in case of treatment with fluoxetine and paroxetine) or mood stabilizers. All of them should only be used after considering benefit and risks. During pregnancy, there should not be switched between different antidepressant drugs. Referring mood stabilizers, the intake of valproic acid should be avoided in pregnancy or at least, dosage should be kept as low as possible since severe teratogenetic effects are known. In addition the specific drug treatment of HIV and hepatitis B during pregnancy is described. During childbirth HIV-infected patients should receive zidovudine intravenously to prevent vertical transmission. Co-infection with hepatitis C cannot be treated during pregnancy, since interferons are associated with a severe risk of fetal malformations and ribavirin has teratogenic effects; for this reason interferon therapy should be started after delivery.