精神科门诊精神药品应用分析

Analysis of the Utilization of Outpatient Psychotropic Drugs in Psychiatric Department

目的:了解某院门诊精神药品使用的特点及规律。方法:对该院2012年门诊精神药品处方,分别按疾病种类、药品名称、用药剂量、合并用药情况进行统计和分析。结果:用药以治疗抑郁症、精神分裂症、失眠症为主。9 354张精神药品处方涉及13个品种,二类精神药品12种,涉及处方9 221张,占处方总数的98.58%;一类精神药品只有一种(哌甲酯),涉及处方133张,占处方总数的1.42%。以氯硝西泮、劳拉西泮、艾司唑仑、阿普唑仑、奥沙西泮排名前5个品种使用频率最高(共占92.05%)。12种药品的药物利用指数(DUI)<1.00,1种药品>1.00。合并用药404例(占4.32%),抑郁症合并用药占合并用药总数的43.07%。结论:苯二氮类以卓越的抗焦虑、镇静、催眠效果,以及较好的安全性和便宜的价格而应用最广。临床需进一步加强对精神药品处方的点评工作。

OBJECTIVE： To investigate the characteristics and rules of the utilization of psychotropic drugs in outpatient department of a hospital. METHODS： All outpatient prescriptions of psychotropic drugs provided by the hospital in 2012 were analyzed statistically according to the types of disease, drug name, drug dosage and drug combination. RESULTS： The drugs mainly were for depression, schizophrenia, insomnia. 9 354 prescriptions involved 13 kinds of psychotropic drugs, among which 12 were Ⅱ psychotropic drugs, involving 9 221 prescriptions, accounting for 98.58% of total; there was only one kind of type Ⅰ psychotropic drugs （methylphenidate）, involving 133 prescriptions, accounting for 1.42% of total. Top 5 drugs in the list of frequency were clonazepam, lorazepam, estazolam, alprazolam and oxazepam （accounting for 92.05% in total） ; DUI of 12 kinds of drugs were lower than 1.00, and that of 1 was higher than 1.00; there were 404 cases of drug combination （accounting for 4.32% ）, combination treatment for depression accounted for 43.07 % of combination therapy. CONCLUSIONS： Benzodiazepines are the most widely used with excellent anti-anxiety, sedative, hypnotic effects, and the further security and affordable price; however, clinical operation should strengthen the reviews on the prescriptions of psychotropic drugs.