1999～2002年上海精神卫生中心抗抑郁药应用分析

目的：了解上海市精神卫生中心近4年来抗抑郁药的用药变化情况，探讨其使用特点及趋势。方法：统计分析了该院在1999—2002年使用抗抑郁药的品种、用量、金额及用药频度、年平均增长率和药品日耗费用等情况。结果：该院在近4年中使用的抗抑郁药金额平均年增长率为13．52％。5-羟色胺再摄取抑制剂在4年中年平均增长率达18．78％，用药金额排位前2名。杂环类抗抑郁药物在用药频度上排位前列。新上市的抗抑郁药用药金额年平均增长率为23．88％，但其使用频度仍排位在后。国产氟西汀类药物的上市，使药品的日耗费用下降，用药金额及频度却大幅度上升。结论：在抗抑郁药使用中还存在用药较为集中的问题。合理选用抗抑郁药，除了考虑疗效确切、不良反应较少外，还需考虑价格适中。

The situation of antidepressants used in Shanghai Mental Health Center during 1999-2002

Objective: To investigate the change in using antidepressants in Shanghai Mental Health Center during recent 4 years and explore the characteristics and trend of use. Methods: Statistical analyses of all the antidepressants used during the period of 1999-2002 in respect of medicine varieties, dosages, cost, frequency of drug use, annual average rate of growth (AARG) and daily drug expenses (DDE) were performed. Results: The AARG of antidepressant cost was 13.52% in our hospital in the 4 years. AARG of selective serotonin re-uptake inhibitors (SSRIs) was increased by 18.78% and the drug cost ranked 1st and 2nd because of the low incidence of adverse drug reaction. Frequency of use of tricyclic antidepressants (TCAs) still ranked head due to low price. The cost of new antidepressants increased greatly (AARG 23.88%) because of the price and medicare policies, but the frequency of drug use still ranked behind. Marketing of the new domestic SSRIs made decrease in the daily cost, but they caused increase in the total cost and frequency of drug use. Conclusion: It is still a problem that the use of antidepressants is too concentrated. For reasonable use of medicine, the attention should be paid to the reasonable price in addition to the exact efficacy and the least adverse drug reaction.