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首页> 外文期刊>The European journal of psychiatry. >Antipsychotics switching strategies in real life: A longitudinal study in clinical practice
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Antipsychotics switching strategies in real life: A longitudinal study in clinical practice

机译：现实生活中的抗精神病药物转换策略：临床实践的纵向研究

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Background and Objectives: Switching antipsychotics (APs) in the treatment of mental ilnesses such as schizophrenia is common practice for clinicians as well as a transitional moment associated with the possibility of adverse events and recurrence of psychoses. As in recent years, AP switching strategies have received more attention, a number of authors have recommended transitions with overlapping drug dosage regimens in time (such as tapering, cross-tapering, plateau switching) over abrupt switches. However, there is a paucity of data documenting how clinicians are switching APs in real life. Moreover, the question if recently recommended switching strategies are converted into everyday practice is still very much unanswered. The present investigation aims to study if indeed there is a preference for tapered approaches over abrupt switching. Methods: In a retrospective longitudinal descriptive study, electronic prescription data from a large clinical psychiatric setting in the Netherlands were collected for the year 2007. Timelines of medication regimens were constructed for individual patients, enabling to identify transitions between APs. As patients could have been subjected to multiple switches in a given time period, transitions were expressed as episodes. Abrupt switches were defined as switches having no overlap in time. Results: From a total of 5322 AP prescriptions involving 1465 patients, a total of 180 episodes (associated with 158 patients) were identified where APs were switched. Of these 180 episodes, 110 (61%) involved abrupt transitions. 70 episodes (39%) had overlap in time with an average taper length of 16.1 (SEM 1.6) days. Conclusions: In the majority of cases in the studied clinical setting, APs are switched abruptly.
机译：背景与目的：在精神分裂症等精神疾病中使用抗精神病药（APs）是临床医生的常见做法，也是与不良事件和精神病复发可能性相关的过渡时期。与近年来一样，AP转换策略已引起更多关注，许多作者建议在突然的开关上及时采用重叠的药物剂量方案进行过渡（例如逐渐变细，交叉渐减，平稳转换）。但是，很少有数据记录临床医生如何在现实生活中转换AP。此外，关于最近推荐的转换策略是否已转换为日常实践的问题仍然悬而未决。本研究旨在研究是否确实比渐进切换更偏向于渐近方式。方法：在一项回顾性纵向描述性研究中，收集了2007年荷兰大型临床精神病学领域的电​​子处方数据。为个别患者建立了药物治疗方案的时间表，从而能够确定AP之间的转换。由于患者可能在给定的时间段内经历了多次转换，因此过渡被表示为发作。突然的开关定义为没有时间重叠的开关。结果：从涉及1465例患者的5 322个AP处方中，总共确定了180例发作（与158例患者相关），其中有AP发生了转换。在这180个情节中，有110个（61％）涉及突然转变。时间上有70次发作（39％）重叠，平均锥度长度为16.1（SEM 1.6）天。结论：在研究的临床环境中，大多数情况下，AP会突然切换。

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