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Pharmacoepidemiol Drug Saf:未成年人抗抑郁药超说明书使用的程度和风险

2017-11-20 吴星 环球医学

2017年11月,发表在《Pharmacoepidemiol Drug Saf.》的一项研究调查了2004年至2011年德国儿童和青少年抗抑郁药超说明书使用的程度和风险。

2017年11月,发表在《Pharmacoepidemiol Drug Saf.》的一项研究调查了2004年至2011年德国儿童和青少年抗抑郁药超说明书使用的程度和风险。

目的:至今,对于儿童患者抗抑郁药标签外使用的研究较少。这是关于德国未成年人抗抑郁药标签外使用趋势和风险的首个研究,分析了年龄、性别、药物类别和超说明书使用类型相关的模式。

方法:研究者使用200万名个体(年龄<18岁)的索赔数据,按照年龄、性别和药物类别,计算2004年至2011年超说明书抗抑郁药处方的份额。分析了标签外处方潜在的诊断、处方医生的专长,以及标签外使用的类型。在一项巢式病例对照研究中,考察了标签外使用和标签内使用的不良事件率,以及标签外和标签内使用相关的自杀事件的风险。

结果:标签外处方率从58.0%降低至40.9%。与三环类抗抑郁药物相比,标签外更频繁处方选择性5-羟色胺再摄取抑制剂(2011年37.7% vs 17.5%)。最常见的标签外使用类型为年龄不符的标签外使用、其次是指征的标签外使用,以及根据禁忌证的标签外使用。不良事件发生率低,标签内与标签外使用没有显着差异。

结论:随着时间的流逝尽管未成年人的抗抑郁药标签外使用有所降低,但其仍较为常见。然而,这表明缺乏治疗这一群体抑郁治疗的批准药物,而非不恰当的用药。与标签内使用相比,标签外使用与较高的不良事件风险不相关的事实支持上述结论。

原始出处:

Schrder C, Drks M, Kollhorst B, et al. Extent and risks of antidepressant off-label use in children and adolescents in Germany between 2004 and 2011. Pharmacoepidemiol Drug Saf. 2017 Nov;26(11):1395-1402. doi: 10.1002/pds.4289. Epub 2017 Aug 24.

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    2018-08-31 爆笑小医
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    2018-08-25 jj000001
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    2018-10-25 wetgdt
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  5. 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  6. [GetPortalCommentsPageByObjectIdResponse(id=1862290, encodeId=9b9a186229063, content=<a href='/topic/show?id=1f0e626267' target=_blank style='color:#2F92EE;'>#Drug#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6262, encryptionId=1f0e626267, topicName=Drug)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Fri Aug 31 03:38:00 CST 2018, time=2018-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787388, encodeId=edcf1e873888f, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, 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content=<a href='/topic/show?id=18849189139' target=_blank style='color:#2F92EE;'>#说明书#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91891, encryptionId=18849189139, topicName=说明书)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3da79876963, createdName=yangpeizhi, createdTime=Wed Nov 22 05:38:00 CST 2017, time=2017-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=263185, encodeId=1ff4263185ce, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Tue Nov 21 22:37:20 CST 2017, time=2017-11-21, status=1, ipAttribution=), 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    2018-08-24 yb6560
  7. 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    2017-11-21 大爰

    学习了谢谢分享!!

    0

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    2017-11-21 神功盖世

    学习

    0

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现代社会,很多人遭受着各种各样的压力,抑郁、焦虑等精神症状越来越常见。据估计,美国大约1/10的人需要依赖抗抑郁药。

Cochrane Database Syst Rev:抗抑郁药治疗儿童和青少年的慢性非癌症疼痛

疼痛是世界各地儿童和青少年的常见特征,世界卫生组织对儿童持续疼痛的药理疗法指导方针承认,儿童疼痛是世界大部分地区的重要公共卫生问题。长期临床证据表明,抗抑郁药对一些神经性疼痛效果显着,但其对疼痛的效果不同于对抑郁症的效果;例如,三环类抗抑郁药对疼痛起效的剂量通常比治疗抑郁症的剂量要低。阿米替林在英国是最常应用的治疗神经性疼痛的药物之一。为了研究儿童疼痛药理学干预证据,研究人员对之前的研究进行分析总

BMJ:停用抗抑郁药是否增加患者焦虑症的复发风险?

2017年9月,发表在《BMJ》上的一项复发预防试验的系统回顾和Meta分析,研究了患者停用抗抑郁药对焦虑症复发率的影响。研究结果证实:在长达1年的随访期中,停用抗抑郁药与继续使用抗抑郁药相比,会造成患者更高的复发率。

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