与长期使用催眠药在抑郁症中相关的因素
Adam Nygren1, Pär Karlsson1, Mikael Tiger2
1Centre for Pharmacoepidemiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
长期使用催眠药在抑郁症患者中很常见,特别是老年人和那些多次处方抗抑郁药的人. 这强调了在这些患者群体中需要谨慎的临床管理.
科学领域:
- 药理学 药理学是指药理学的学科.
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 催眠药经常被用于治疗抑郁症,但影响其长期使用的因素尚不清楚.
- 了解这些因素对于优化抑郁症管理中的治疗和患者结果至关重要.
研究的目的:
- 确定与长期使用催眠药在被诊断患有抑郁症的成年患者中相关的因素.
- 在现实世界的临床环境中调查持续催眠处方的患病率和预测因素.
主要方法:
- 一项使用瑞典国家卫生登记册 (2007-2018) 的回顾性队列研究.
- 包括被诊断患有抑郁症的18岁以上的患者,不包括患有痴呆症,双相情感或精神疾病的患者.
- 长期使用定义为每天超过180剂,超过一年的3次填充;逻辑回归分析了相关因素.
主要成果:
- 包括78,383名患有抑郁症的患者;30.0%符合长期使用催眠药的标准.
- 年龄较大 (≥70岁) 和更多的先前抗抑郁药处方 (≥3) 与长期使用催眠药有很强的关联.
- 二甲类催眠药 (Z-药物) 是最常见的催眠药.
结论:
- 长期使用催眠药在患有抑郁症的患者中普遍存在,特别是在老年人中.
- 多次先前的抗抑郁药试验是长期使用催眠药的重要预测因素,表明治疗耐药性.
- 临床注意力应集中在老年患者和那些有多次抗抑郁药治疗史的人身上,以有效地管理催眠使用.
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