我院住院患者精神药物使用现状

精神药物对精神疾病的治疗起着极其重要的作用。为了解我院目前精神药物使用情况，为今后精神药物进一步的合理应用，提高精神病的治愈率，我们于1994年6月15日对我院6个病区的住院患者进行调查，报告如下；     

精神药物使用情况调查

对我院精神药物使用情况和趋势调查分析 ,报告如下。1　资料与方法资料系 1998～ 2 0 0 1年我院精神药物使用数量和金额。采用ＷＨＯ推荐的限定日剂量 (ＤＤＤ) ,其确定根据《新编药物学》第 14版[1] 、《新编临床精神药物手册》[2 ] 制定 ,新药以药品说明书为准。计算ＤＤＤ数 ,将各种药物的ＤＤＤｓ(总用药量 /该药ＤＤＤ)与金额排序进行统计分析。2　结果各种精神药物ＤＤＤｓ、金额及其排序变化见表 1。精神药物各年度总消耗金额 1998年为 5 2 8% ,1999年为 6 4 0 % ,2 0 0 0年为 6 6 8% ,2 0 0 1年为 75 2 %。药品收入占医院总收入…     

我院门诊精神药物使用现状

精神药物对精神疾病的治疗起着极其重要的作用，为了进一步了解精神药物在我院的使用情况，我们调查了我院精神科门诊患者的用药情况，现将调查的内容总结分析如下：     

住院精神病人精神药物使用情况

为了解住院患精神药物的使用情况,以1998年12月1日为调查日,共调查四所精神病院,其中一所为全部住院患,三所为随机抽取男女各一个病区的住院患。用自制的调查表,登记当日使用药物的品种、剂量及合用安坦和苯二氮Zho物的情况,共计549例。结果：住院患以氯丙嗪和氯氮平最常用,分别为60.1%和59.7%,第3－6位依次为氟呱啶醇5.6％,维思通5.1%,舒必利3.8%,奋乃静3.3%。由于氯丙嗪和氯氮平较为有效、安全和价廉,故成为临床最常用的精神药物。     

精神科住院病人精神药物使用情况调查

目的：了解目前住各精神药物的使用情况。方法：以１９９８年１２月１日为调查日,共调查４所精神病院,１所为全部住院患者,３所为分别随机抽取男女各１个病区的住院患者。用自制的调查表调查当日用药情况,共调查５４９例。结果：住院患者的用药以氯丙嗪和氯氮平最常用,分别为６０．１％和５９．７％,以后依次为氟哌啶醇,和利和奋乃静。结论：由于氯丙嗪和氯氮平较为有效,安全和价廉,故成为临床最常用的精神药物     

131例住院老年精神病人精神药物使用情况调查

１９９５年６月１４日对上海市精神卫生中心１３１例６０岁以上的住院精神病人精神药物的使用情况进行了调查，结果精神药物使用频度列在前三位的依次为氯氮平、氯丙嗪及奋乃静，用药方案列在前三位者依次为氯丙嗪、氯氮平及奋乃静。单一用药为主要治疗方案；主要抗抑郁剂为麦普替林和氧西汀，药物剂量小，安坦使用频率低，用药趋于合理。     

精神药物的副反应

精神药物的副反应陈建华吴超全权贞子康正姬展西友孙兆田王建新王秋艳李仕荣刘建英刘开成徐立志刘信贾凯候兆香崔学才李万和李晶李国兰牟建明范新刚颜玉景李玉兰周锦泉常瑞莲刘茂祥赵兆兰冼易平顾小扬孙菊水欧国蓬冯晓蓉张连英李凯骐张月英张化梅杨明健齐钢桥冯健高霞袁有...     

首发首诊住院分裂症患者精神药物使用情况调查

目的 了解首发首诊住院分裂症患者精神药物的使用情况。方法 自2000年全部首次住院病例中，选择符合CCMD-2-R精神分裂样精神病标准者673例。结果 首选单一用药者587例(92．15％)，常用药物依次为氟哌啶醇占64．52％，氯氮平占14．76％，氯丙嗪占7．69％，舒必利占2．83％，其他药物的使用率均不足1％，首选联合用药者50例(7．85％)，最常见的是氯氮平联合舒必利占4．71％，合用安坦者510例(80．06％)。结论 对初治分裂症的首选用药，仍以经典抗精神病药为主，不应联合用药，必要时可舍用增效剂，氯氮平不宜做为首选用药。     

Consumption of psychotropic drugs in elderly persons registered at the home nursing centre in Bergen,Norway

The regular use of psychotropic drugs in all patients aged 70 yr and over who were registered at the home nursing centre was studied. 27.4% of the patients used psychotropic drugs, 11.9% used antipsychotics, 14.6% anxiolytics and hypnotics/sedatives and 6% antidepressants. The use of antipsychotics was increased in mentally impaired patients and in wandering, restless aggressive persons, but declined with increasing age. Anxiolytics and hypnotics/sedatives and antidepressants were more frequently used by apathetic/passive/anxious patients. The dosage of antipsychotics declined with age. The doses are usually in line with general suggestions. Drugs in which the efficacy is judged by the patients themselves seem to be taken in higher doses than drugs in which the efficacy is determined by the physician.     

The rational use of psychotropic drugs in pregnancy and postpartum

When a pregnant woman or nursing mother requires psychotropic medication, one must consider the effect of such medications on the fetus or baby. The authors review the evidence for teratogenic effects of such drugs given during pregnancy, toxic or withdrawal effects in the newborn and dangers to the breast-fed baby. Suggestions are made for judicious use of psychotropic drugs in pregnant or nursing women.     

Neurodevelopmental effects of prenatal exposure to psychotropic medications

Until now, studies on the reproductive safety of psychotropics have typically assessed the risk of congenital malformations and perinatal complications associated with in utero exposure to such medications. However, little is known of their inherent potential neurobehavioral teratogenicity. The objective is to analyze available data from studies investigating developmental outcome of children exposed prenatally to psychotropics. A computerized Medline/PubMed/TOXNET/ENBASE search (1960–2010) was conducted using the following keywords: pregnancy, child/infant development/neurodevelopment, antidepressants, benzodiazepines, mood stabilizers, and antipsychotics. A separate search was also run to complete the safety profile of single specific medications. Resultant articles were cross‐referenced for other relevant articles not identified in the initial search. A noncomputerized review of pertinent journals and textbooks was also performed. All studies published in English and reporting primary data on the developmental outcome of infants exposed in utero to psychotropics and born without malformations were collected. As regards antiepileptic drugs, only studies that provided data on specific medications approved for psychiatric practice use (carbamazepine, lamotrigine, and valproate) were considered. Data were extracted from 41 articles (38 identified electronically and 3 nonelectronically), which met the inclusion criteria. Despite reviewed studies showing relevant methodological limitations, concordant, albeit preliminary, information seems to exclude that prenatal exposure to both selective serotonin reuptake inhibitors and tricyclic antidepressants may interfere with the infants' psychological and cognitive development. Conversely, information on valproate strongly discourages its use in pregnant women. Moreover, although data on carbamazepine remain controversial, information on whole classes of drugs and single medications is either absent (second‐generation antipsychotics) or too limited (first‐generation antipsychotics, benzodiazepines, lithium, and lamotrigine) to inform the decision‐making process. For all classes of psychotropics, new and/or further studies are warranted to answer definitively the urgent question about the impact of prenatal exposure to such medications on infant development. Depression and Anxiety, 2010. © 2010 Wiley‐Liss, Inc.     

精神疾病患者孕产期治疗探讨

目的：探讨精神疾病患者孕产期治疗方法。方法：回顾性分析1999年1月至2007年4月期间足月妊娠分娩的192例精神疾病患者的临床资料。结果：68例发作期的患者分娩时,剖宫产38例（56、7％）,其中无产科原因而因精神症状剖宫产20例（29.9％）;稳定期患者124例,剖宫产38例（30．6％）,99例妊娠中晚期坚持服抗精神病药,新生儿出生情况良好,未见畸形。结论：精神疾病患者孕中晚期抗精神病药维持治疗很有必要,对发作期的患者分娩时适当放宽剖宫产指征,以保障母婴安全;产后及时、足量恢复抗精神病药使用。     

Social factors associated with the use of psychotropic drugs: alcohol abuse and minor psychiatric morbidity in the community

The association of socio-demographic factors and life events with psychotropic drug consumption, alcohol abuse and minor psychiatric morbidity was investigated in a representative community sample of 181 respondents. The statistical model used was a logistic multiple regression analysis. Psychotropic drug use was best predicted by family size and employment status; alcohol abuse by sex, family size and "exit" events; and minor psychiatric morbidity by sex, marital status and undesirable life events.