Differences in prescription patterns between real-world outpatients with bipolar I and II disorders in the MUSUBI survey
Differences in prescription patterns between real-world outpatients with bipolar I and II disorders in the MUSUBI survey
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DOI：
10.1016/j.ajp.2021.102935
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发表时间：
2021-11-26
影响因子：
9.5
通讯作者：
Yoshimura, Reiji
中科院分区：
文献类型：
--
作者：
Shinozaki, Masataka;Yasui-Furukori, Norio;Yoshimura, Reiji
目的：关于 I 型双相情感障碍 (BD-I) 和 II 型双相情感障碍 (BD-II) 患者精神药物处方的信息有限。本研究的目的是调查 BD-I 和 BD-II 门诊患者的药物治疗特点，特别是抗抑郁药物。方法：2017 年，日本精神科诊所双相情感障碍多中心治疗调查（MUSUBI）研究收集了 2774 名 BD-I 或 BD-II 门诊患者当前精神状态、药物治疗和其他因素的数据。情绪稳定剂、抗精神病药和抗抑郁药的处方率。 BD-I 患者服用情绪稳定剂和抗精神病药的比例较高（情绪稳定剂；BD-I 86.0%，BD-II 80.8%，p < 0.001；抗精神病药；BD-I 61.5%，BD-II 47.8%，p < 0.001）；BD-II 患者服用抗抑郁药的比例较高（BD-I） 32.1%，BD-II 46.4%，p < 0.001）。最常用的抗抑郁药是针对 BD-I 患者的艾司西酞普兰和针对 BD-II 患者的度洛西汀。选择性血清素再摄取抑制剂 (SSRI) 是为双相情感障碍患者开出的最常见的一类抗抑郁药。在联合治疗方面，BD-II患者经常开出含有抗抑郁药物的组合药物。结论：BD-I和BDII患者在精神药物处方方面存在差异。日本BD的门诊处方为情绪稳定剂和抗精神病药，一般遵循指南。关于处方抗抑郁药的作用和躁狂发作的风险，没有足够的证据，需要收集进一步的证据。
Objective: There is limited information available on the prescription of psychotropic agents to patients with bipolar I (BD-I) and bipolar II disorder (BD-II). The purpose of this study was to investigate the characteristics of drug therapy in BD-I and BD-II outpatients, particularly with regard to antidepressants.Methods: In 2017, the MUlticenter treatment SUrvey for BIpolar disorder in Japanese psychiatric clinics (MUSUBI) study collected data on current mental status, medications, and other factors from 2774 outpatients with BD-I or BD-II.Results: There were significant differences in the rates of prescriptions for mood stabilizers, antipsychotics and antidepressants. Mood stabilizers and antipsychotics were prescribed at higher rates to patients with BD-I (mood stabilizers; BD-I 86.0%, BD-II 80.8%, p < 0.001; antipsychotics; BD-I 61.5%, BD-II 47.8%, p < 0.001), and antidepressants were prescribed at higher rates to patients with BD-II (BD-I 32.1%, BD-II 46.4%, p < 0.001). The most commonly prescribed antidepressants were escitalopram for patients with BD-I and duloxetine for patients with BD-II. Selective serotonin reuptake inhibitors (SSRIs) were the most common class of antidepressants prescribed to patients with BD. With regard to combination therapy, combinations containing antidepressants were often prescribed to patients with BD-II.Conclusion: There was a difference in the prescription of psychotropic agents between patients with BD-I and BDII. The outpatient prescriptions for BD in Japan were mood stabilizers and antipsychotics, which generally followed the guidelines. There is insufficient evidence regarding the effects of the prescribed antidepressants and the risk of manic episodes, and further evidence needs to be collected.