综合医院门诊抑郁障碍和焦虑障碍患者处方变化分析

Trend and Change of Antipsychotic Prescriptions of Anxiety Disorders and Depressive Disorders in Out-patient Clinic

目的调查某大型三甲综合医院门诊抑郁障碍和焦虑障碍的处方5年前后变化情况,分析临床药物治疗演变规律。方法以2010年及2015年全年作为2个调查时段,根据相关诊断导出相对应的处方,分析比较其中的精神类药物的使用情况。结果 2015年抑郁障碍和焦虑障碍门诊治疗上使用占比高的药物分别为选择性5-HT再摄取抑制剂(SSRI,27%)、第二代抗精神病药(SGA,19.9%)、苯二氮卓类(BDZ,18.5%)及选择性5-HT/NE再摄取抑制剂(SNRI,15.5%),单药治疗中SSRI(51.7%)及SNRI(40%)占有相当大的比例,联合治疗中占比高的为SSRI(31.8%)、SGA(26%)及SNRI(17.4%);2015年较2010年相比,β受体阻断剂及三环类占比明显下降,联用药物数量较之前明显减少,从3药联合变为以双药联合治疗为主。结论综合医院抑郁障碍和焦虑障碍门诊治疗药物选择较5年前更加规范和个体化;选择疗效良好、不良反应轻微的药物及联合用药已成为主要趋势。

OBJECTIVE To investigate the changes of anti-anxiety and anti-depression prescriptions in a large general hospital over the 5 years and to find the trend of drug therapy. METHODS Reviewed the prescriptions of anxiety and depression disorder patients in outpatient, respectively in 2010 and 2015, and analyzed the proportion of medication. RESULTS In 2015, the most medication for anxiety and depression disorder were SSRI, SGA, BDZ, SNRI. The most of proportion were SSRI and SNRI in monotherapy, and SSRI, SNRI and SGA in combined treatment. The large changes between 2015 and 2010 were that proportions of β-blockers and TCAs were dropping dramatically and the combined treatment with 3 drugs was replaced by 2 drugs in the majority medication. CONCLUSION Medication for anxiety and depression disorder in the general hospital tends to choice the higher efficacy and mildly side-effect drugs and combined treatment.