老年科住院患者抗抑郁药物应用77例分析

Antidepressant treatment for elderly inpatients in geriatric ward:an analysis of 77 cases

目的探讨老年人应用抗抑郁药的安全性,为老年人合理使用抗抑郁药提供参考。方法回顾性分析2012年1月至2013年12月北京协和医院院老年示范病房77例65岁以上患者的抗抑郁药物的使用情况、起始剂量及不良反应。结果经老年医学跨学科团队会诊,77例均服用新型抗抑郁药,其中舍曲林使用率最高,对低体重指数患者更多选择米氮平治疗,伴有慢性疼痛的患者中50%使用5-羟色胺和(或)去甲肾上腺素再摄取抑制剂。70例住院后开始抗抑郁药治疗,72.8%的患者初始给药量从小剂量开始,不良反应发生率为8.6%(6/70)。结论应结合老年患者特点,以及抗抑郁药的特点、不良反应和药物之间的相互作用来选择适当的抗抑郁药物。

Objective To explore the safety of antidepressants in treatment of elderly patients and provide a basis for ration- al use of medication. Methods A retrospective chart review was conducted on 77 inpatients aged over 65 years treated with antidepressants in Geriatric Ward of our hospital. Data on medications, initial doses and adverse reactions were collected and analyzed. Results All patients were treated with the second-generation antidepressants after consultation by muhidiscipli- nary geriatric team. Sertraline was the most common medication. Most of the patients with a lower body mass index （BMI） chose mirtazapine. Half of the patients with chronic pain chose to use SNRIs. Seventy patients took antidepressants after hos- pitalization,72. 8% of them with a low initial dose. The incidence of adverse reaction was 8.6% （6/70）. Conclusion Healthy problems of the elderly patients, characteristics of medications, adverse reactions and drug-drug interactions may be taken into consideration for the right choice of an antidepressant.