International Consensus Study of Antipsychotic Dosing
International Consensus Study of Antipsychotic Dosing
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DOI：
10.1176/appi.ajp.2009.09060802
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发表时间：
2010-06-01
影响因子：
17.7
通讯作者：
Baldessarini, Ross J.
中科院分区：
文献类型：
--
作者：
Gardner, David M.;Murphy, Andrea L.;Baldessarini, Ross J.
目的：抗精神病药物的等效效力需要指导临床剂量和设计和解释研究。可用的给药指南是有限的方法和数据，他们generated.Method：与两步德尔菲法，作者调查了不同的国际临床和研究专家组，寻求共识，关于抗精神病药物的剂量。作者确定了中位数的临床剂量当量，并建议开始，目标范围，和最大剂量为61种药物，调整选定的临床环境environment.Results：参与者（N=43）从18个国家提供了关于治疗精神障碍的37口服药物和14个短效和10个长效胃肠外药物的剂量建议。以奥氮平20 mg/天作为参考，口服药物的估计临床等效性比值范围为舒必利0.025至三氟哌利多10.0。17例患者和治疗特征，包括年龄，肝和肾功能，疾病阶段和严重程度，性别，和诊断，与剂量modifies.Conclusion：在没有足够的前瞻性，随机药物药物比较，目前的研究结果提供了广泛的，国际，专家共识为基础的建议，大多数临床使用的抗精神病药物。他们可以支持临床实践，试验设计和比较抗精神病药物试验的解释。(Am J Psychiatry 2010; 167：686-693）
Objective: Potency equivalents for antipsychotic drugs are required to guide clinical dosing and for designing and interpreting research studies. Available dosing guidelines are limited by the methods and data from which they were generated.Method: With a two-step Delphi method, the authors surveyed a diverse group of international clinical and research experts, seeking consensus regarding antipsychotic dosing. The authors determined median clinical dosing equivalents and recommended starting, target range, and maximum doses for 61 drugs, adjusted for selected clinical circumstances.Results: Participants (N=43) from 18 countries provided dosing recommendations regarding treatment of psychotic disorders for 37 oral agents and 14 short-acting and 10 long-acting parenteral agents. With olanzapine 20 mg/day as reference, estimated clinical equivalency ratios of oral agents ranged from 0.025 for sulpiride to 10.0 for trifluperidol. Seventeen patient and treatment characteristics, including age, hepatic and renal function, illness stage and severity, sex, and diagnosis, were associated with dosing modifications.Conclusion: In the absence of adequate prospective, randomized drug-drug comparisons, the present findings provide broad, international, expert consensus-based recommendations for most clinically employed antipsychotic drugs. They can support clinical practice, trial design, and interpretation of comparative antipsychotic trials. (Am J Psychiatry 2010; 167:686-693)