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Maintenance phase treatment of psychotic disorders in outpatients from Serbia - focus on long-term benzodiazepine use.
International Journal of Psychiatry in Clinical Practice ( IF 2.144 ) Pub Date : 2020-05-27 , DOI: 10.1080/13651501.2020.1767788
Nađa P Marić,Sanja Andrić Petrović,Stefan Jerotić,Ivan Ristić,Bojana Savić,Mirjana Zebić,Vuk Vuković,Dubravka Britvić,Olivera Golubović,Marko Jakšić,Katarina Jevđić,Zorica Kolašinac,Nikola Lalović,Jasminka Mirković Ilić,Slavica Nikolić,Čedica Paunović,Zorana Pavlović,Slobodanka Pejović Nikolić,Vukašin Perović,Jelena Popović,Vesna Ranđić Avakumović,Snežana Stojanović,Milan Tatarević,Ivana Živković,Tatjana Voskresenski,Nikolina Jovanović

Introduction: Prescribing trends in maintenance therapy of patients with primary psychotic disorders (PSD) may vary worldwide. Present study aimed to investigate prescription patterns in a sample of outpatients with PSD from Serbia.

Methods: In a sample of 73 PSD outpatients we analysed the rate of antipsychotic polypharmacy and psychotropic polypharmacy, concomitant continual benzodiazepine use, and associations between therapy, psychotic symptoms and quality of life.

Results: Maintenance therapy (median daily dose 321 mg of chlorpromazine equivalents) predominantly consisted of monotherapy with second generation antipsychotics (45.2%), followed by antipsychotic polypharmacy based on first and second generation combination (25.0%). The median number of psychotropic drugs was 3. Benzodiazepines were continually prescribed to more than 60% of patients (mean daily dose 2.9 ± 2.0 mg lorazepam equivalents). Patients with benzodiazepine use had significantly more psychotropic medications and more antipsychotic polypharmacy, poorer quality of life and more severe psychopathology in comparison to another group.

Conclusion: The present study demonstrated new information regarding the prescription patterns of psychotropic drugs in outpatients with PSD in Serbia, amplified with clinically relevant information. This study also revealed distinct prescription patterns concerning antipsychotic/benzodiazepine polypharmacy. Overall, such findings are likely to contribute to improving clinical practice and care for patients with PSD in general.

  • Keypoints
  • Present exploratory research aimed to elucidate trends of antipsychotics polypharmacy and concomitant use of psychotropic medications including benzodiazepines in the maintenance treatment of outpatients with schizophrenia and other psychotic disorders, amplified with clinically relevant information (symptoms and quality of life).

  • ‘Antipsychotic (AP) polypharmacy’ was defined as concurrent use of more than one AP for at least 1 month; ‘Psychotropic polypharmacy’ was defined as the combination of AP and a different class of psychotropic drugs medication for at least one month.

  • The median number of prescribed psychotropic drugs was 3 (mean 3.1 ± 1.1) and the average AP daily dose was moderate (median 321 mg of chlorpromazine equivalents). However, the rates of AP polypharmacy (45.2%) and benzodiazepine prescription on a continual basis (>60%) found in our sample could be considered relatively high.

  • Outpatients with higher AP daily dose and higher BPRS symptom score were receiving more benzodiazepines.

  • For improvement of the local, as well as general clinical practice and care for patients with psychotic disorders, and for education in psychiatry, such analyses need to be done on a regular basis and on larger samples.



中文翻译:

塞尔维亚门诊病人精神病的维持期治疗-重点是长期使用苯二氮卓类药物。

简介:在世界范围内,原发性精神病患者(PSD)维持治疗的处方趋势可能有所不同。目前的研究旨在调查来自塞尔维亚的门诊PSD患者的处方模式。

方法:在73名PSD门诊患者的样本中,我们分析了抗精神病药和精神病药的比例,苯并二氮杂并持续使用以及治疗,精神病症状和生活质量之间的关联。

结果:维持治疗(日剂量氯丙嗪当量的中位日剂量为321 mg)主要包括第二代抗精神病药的单药治疗(45.2%),然后是基于第一代和第二代组合的抗精神病药房(25.0%)。精神药物的中位数为3。超过60%的患者持续服用苯二氮卓类药物(平均日剂量为2.9±2.0 mg劳拉西m当量)。与另一组相比,使用苯二氮卓类药物的患者服用的精神药物明显增多,抗精神病药的使用增多,生活质量较差,精神病理学更为严重。

结论:本研究证明了有关塞尔维亚门诊PSD患者精神药物处方模式的新信息,并通过临床相关信息进行了放大。这项研究还揭示了有关抗精神病药/苯并二氮杂poly多药的独特处方模式。总体而言,这些发现很可能有助于改善PSD患者的临床实践和护理。

  • 关键点
  • 当前的探索性研究旨在阐明抗精神病药多药房的趋势以及包括苯二氮卓类在内的精神药物在维持精神分裂症和其他精神病患者的门诊治疗中的应用,并结合临床相关信息(症状和生活质量)进行放大。

  • “抗精神病药(AP)混合药房”的定义是同时使用至少一种AP并持续至少1个月;“精神药物综合药房”的定义是将AP和另一类精神药物合用至少一个月。

  • 开处方的精神药物的中位数为3(平均3.1±1.1),平均AP日剂量为中等(中位数321 mg氯丙嗪当量)。但是,在我们的样本中发现的AP多药房(45.2%)和苯二氮卓类药物处方连续出现率(> 60%)被认为是相对较高的。

  • AP日剂量较高和BPRS症状评分较高的门诊患者接受更多的苯二氮卓类药物。

  • 为了改善精神病患者的当地以及一般临床实践和护理,以及进行精神病学教育,需要定期对此类分析进行分析,并采用较大样本进行分析。

更新日期:2020-05-27
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