Low use of neuroleptic drugs in the treatment of psychotic major depression.
Low use of neuroleptic drugs in the treatment of psychotic major depression.
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DOI：
10.1176/ajp.154.4.559
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发表时间：
1997-04
期刊：
影响因子：
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通讯作者：
B. Mulsant;R. Haskett;J. Prudic;M. Thase;K. Malone;J. Mann;H. Pettinati;H. Sackeim
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文献类型：
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作者：
B. Mulsant;R. Haskett;J. Prudic;M. Thase;K. Malone;J. Mann;H. Pettinati;H. Sackeim
目的评价精神病性抑郁症患者接受药物治疗的充分性。方法对187例抑郁症患者在开始ECT治疗前的药物治疗进行系统评价，并对精神病性抑郁症（53例）和非精神病性抑郁症（134例）的药物试验进行比较。结果：尽管中位有4次药物试验，中位指数发作持续时间为20周，但只有2例（4%）精神病性抑郁症患者接受了至少一次充分的药物治疗试验。相比之下，70例（52%）非精神病性抑郁症患者接受了至少一次充分的试验。25例（47%）精神病性抑郁症患者未接受抗精神病药物治疗（N = 11）或治疗少于3周（N = 14）。只有8人（15%）每天接受的神经安定药剂量高于200毫克氯丙嗪当量。结论：这些发现表明，许多精神病性抑郁症患者转介ECT接受药物治疗不足，因为无论是缺乏或不充分使用抗精神病药物。
OBJECTIVE The adequacy of pharmacologic treatment received by patients with psychotic major depression was evaluated. METHOD The authors systematically assessed the pharmacotherapy received by 187 depressed patients before initiation of ECT and compared the medication trials of those with psychotic (N = 53) and nonpsychotic (N = 134) depression. RESULTS Despite a median of four medication trials and median index episode duration of 20 weeks, only two (4%) of the patients with psychotic depression received at least one adequate pharmacotherapy trial. In contrast, 70 (52%) of the patients with nonpsychotic depression received at least one adequate trial. Twenty-five (47%) of the patients with psychotic depression received either no neuroleptic treatment (N = 11) or treatment for less than 3 weeks (N = 14). Only eight (15%) received a daily neuroleptic dose higher than 200 mg of chlorpromazine equivalents. CONCLUSIONS These findings suggest that many patients with psychotic major depression referred for ECT receive inadequate pharmacotherapy because of either the absence or the inadequate use of neuroleptic medication.