双极性抑郁症的治疗:临床实践与遵守指南-来自巴伐利亚药物监测项目的数据
Paul Kriner1, Peter Brieger2, Oliver Pogarell3
1Department of Psychiatry and Psychotherapy, kbo-Lech-Mangfall-Klinik Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany.
Frontiers in psychiatry
|July 17, 2024
概括
许多双极性抑郁症患者没有接受指导方针推的治疗方法,这表明证据和实践之间存在差距. 这凸显了对双极性抑郁症药物治疗的更好的实施策略的需要.
科学领域:
- 精神病学是一个精神病学.
- 临床药理学 临床药理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 双极性抑郁症 (BPD) 药物治疗面临挑战,包括有限的基于证据的选择,治疗耐药性和情感切换风险.
- 临床指导方针旨在支持基于证据的决策,以治疗BPD.
- 2019年德国S3指南提供了诊断和治疗双相情感障碍的建议.
研究的目的:
- 评估住院临床实践是否符合2019年德国S3关于BPD治疗的指南.
- 为了确定当前的药物治疗趋势和偏离住院患者的指导方针建议.
主要方法:
- 对来自巴伐利亚住院患者的2627名BPD患者的处方数据的描述性分析 (2014-2022年).
- 来自制药流行病学和警 (Pharmako-EpiVig) 项目的数据.
- 药物处方模式的评估,包括单疗法,组合疗法和特定药物类别.
主要成果:
- 38%的患者没有接受指导方针推的药物 (quetiapine,lamotrigine,carbamazepine,olanzapine);只有6%接受单一治疗.
- 72%的人接受抗抑郁药,通常没有同时服用非典型抗精神病药物 (AAP) 或情绪稳定剂 (MS).
- 的处方增加了 (29%至35%),而氨酸减少了 (22%至14%). 奎蒂亚平是最常被处方的AAP (43%).
结论:
- 在BPD治疗指南和临床实践之间存在很大的差距,治疗异质性证明了这一点.
- 增加的处方是积极的,但需要对组合疗法的全面建议.
- 未来的研究应该专注于随机对照试验,调查实施策略,以改善准则的遵守.
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