Zusammenfassung
HINTERGRUND: Beobachtung der Veränderung von Verschreibungsgewohnheiten in der Therapie der Bipolaren Erkrankung in einem klinischen Setting und Vergleich mit den Therapierichtlinien. METHODE: Erfassung und statistische Auswertung von Daten aller bipolaren Patienten, die zwischen Jänner 2002 und Juni 2005 an der Universitätsklinik für Psychiatrie 1, Salzburg, stationär aufgenommen wurden. ERGEBNISSE: Insgesamt wurden Daten von 336 Patienten (117 männlich, 219 weiblich) und 1512 stationären Aufenthalten erfaßt. Es zeigte sich in der Entlassungsmedikation ein deutlicher Trend zugunsten von Valproinsäure und atypischen Antipsychotika (Quetiapin, Olazapin und Risperidon), die Verordnung von Lithium und typischen Antipsychotika scheint dagegen rückläufig zu sein. Die häufigste Strategie zur Behandlung der Manie war eine Kombination von Valproinsäure mit einem atypischen Antipsychotikum, in der Depression eine Dreifachkombination aus Antidepressivum, Antipsychotikum und Valproinsäure. Antidepressiva wurden regelmäßig zur Therapie depressiver Phasen verschrieben, jedoch immer als Teil einer Kombinationsstrategie. SCHLUSSFOLGERUNG: Seit 2002 kam es zu einer deutlichen Veränderung der Verschreibungsgewohnheiten mit Trend zu sogenannten modernen Psychopharmaka. Mit der Ausnahme des regelmäßigen Gebrauchs von Antidepressiva in der bipolaren Depression war die Einhaltung der Therapierichtlinien gut.
Summary
OBJECTIVE: A Survey of changes in prescription patterns for Bipolar Disorder in a clinical setting and of adherence to therapy guidelines. METHODS: We collected data about demographic variables, diagnosis and discharge medication of all patients diagnosed with bipolar disorder admitted to the University Clinic for Psychiatry I, Salzburg, between January 2002 and June 2005. RESULTS: 336 patients (117 male, 219 female) and data from 1512 different hospital admissions were included in the survey. We found a clear trend towards valproate and atypical antipsychotics in discharge medication, whereas lithium and typical antipsychotics showed a decreasing quota of prescriptions during the time of the survey. The most frequently used medication in manic patients was a combination of valproate and atypical antipsychotics (quetiapine, olanzapine and risperidone), in depressive patients a triple combination of an antidepressant, valproate and an atypical antipsychotic. Antidepressants were routinely used in the treatment of bipolar depression (99% of all cases), albeit always as a part of a combination strategy. CONCLUSIONS: Since 2002, a substantial change of prescription patterns in bipolar patients has taken place, with a trend towards valproate and atypical antipsychotics and against lithium and typical antipsychotics. In general, adherence to treatment guidelines was high, with the exception of regular use of antidepressants in bipolar depression.
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Mühlbacher, M., Egger, C., Nickel, M. et al. Veränderungen der Verschreibungsgewohnheiten in der medikamentösen Behandlung der Bipolaren Erkrankung. Psychiatrie 1, 57–62 (2005). https://doi.org/10.1007/s11326-005-0009-3
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DOI: https://doi.org/10.1007/s11326-005-0009-3