Abstract Objective: Comorbid mental illness is extremely common in individuals receiving opioid substitution therapy. The use of common psychiatric medications is complex in this cohort with increased risks of drug–drug interaction, overdose, and diversion or abuse of prescribed medication. We have therefore investigated rates of co-prescribing and psychiatric comorbidity in a cohort of individuals receiving therapeutic methadone or buprenorphine. Methods: Comprehensive electronic medical records were accessed for a cohort of individuals (n = 698) receiving opioid substitution therapy at a single center in London, United Kingdom. The following was collected for each individual: demographic data, current prescribed medications (including opioid substitution therapy agents), duration of prescription, indication for each prescription, and psychiatric diagnoses. Results: A total of 610 individuals were included in the final analysis. High rates of psychotropic co-prescribing were observed, with 36.7% of individuals receiving a psychotropic medication in addition to their opioid substitution drug, including 35.4% receiving an antidepressant, 9.2% an antipsychotic, 8.6% a benzodiazepine, and 4.5% a gabapentinoid, rates that are far in excess of the local population prescription frequency; 75.5% of antipsychotic prescriptions and 47.7% of benzodiazepine prescriptions were for an unlicensed indication. Conclusions: This highlights the need for evidence-based treatment of comorbid mental illness for individuals receiving opioid substitution therapy.

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在阿片类药物替代治疗队列中使用处方精神药物

摘要 目的：在接受阿片类药物替代治疗的个体中，共病精神疾病极为常见。在该队列中，常见精神科药物的使用很复杂，药物相互作用、过量用药以及处方药物的转移或滥用风险增加。因此，我们调查了一组接受治疗性美沙酮或丁丙诺啡的个体的共同处方和精神疾病合并症的发生率。方法：访问了在英国伦敦的一个中心接受阿片类药物替代治疗的一组个体（n = 698）的综合电子病历。为每个人收集了以下信息：人口统计数据、当前处方药物（包括阿片类药物替代治疗药物）、处方持续时间、每个处方的适应症、和精神科诊断。结果：最终分析共纳入610人。观察到精神药物联合处方的比例很高，36.7% 的人除了接受阿片类药物替代药物外还接受精神药物治疗，其中 35.4% 接受抗抑郁药，9.2% 接受抗精神病药，8.6% 接受苯二氮卓类药物，4.5% 接受加巴喷丁，远远超过当地人口处方频率的比率；75.5% 的抗精神病药处方和 47.7% 的苯二氮卓处方用于未经许可的适应症。结论：这凸显了对接受阿片类药物替代治疗的个体合并精神疾病进行循证治疗的必要性。观察到精神药物联合处方的比例很高，36.7% 的人除了接受阿片类药物替代药物外还接受精神药物治疗，其中 35.4% 接受抗抑郁药，9.2% 接受抗精神病药，8.6% 接受苯二氮卓类药物，4.5% 接受加巴喷丁，远远超过当地人口处方频率的比率；75.5% 的抗精神病药处方和 47.7% 的苯二氮卓处方用于未经许可的适应症。结论：这凸显了对接受阿片类药物替代治疗的个体合并精神疾病进行循证治疗的必要性。观察到精神药物联合处方的比例很高，36.7% 的人除了接受阿片类药物替代药物外还接受精神药物治疗，其中 35.4% 接受抗抑郁药，9.2% 接受抗精神病药，8.6% 接受苯二氮卓类药物，4.5% 接受加巴喷丁，远远超过当地人口处方频率的比率；75.5% 的抗精神病药处方和 47.7% 的苯二氮卓处方用于未经许可的适应症。结论：这凸显了对接受阿片类药物替代治疗的个体合并精神疾病进行循证治疗的必要性。远远超过当地人口处方频率的比率；75.5% 的抗精神病药处方和 47.7% 的苯二氮卓处方用于未经许可的适应症。结论：这凸显了对接受阿片类药物替代治疗的个体合并精神疾病进行循证治疗的必要性。远远超过当地人口处方频率的比率；75.5% 的抗精神病药处方和 47.7% 的苯二氮卓处方用于未经许可的适应症。结论：这凸显了对接受阿片类药物替代治疗的个体合并精神疾病进行循证治疗的必要性。