儿童和青少年抑郁障碍用药处方趋势及不良反应分析

doi:10.19803/j.1672-8629.20240664

摘要/Abstract

摘要： 目的探讨真实世界儿童和青少年抑郁障碍患者临床用药情况,分析药物选择和发展趋势,为临床合理用药提供参考。方法分析2019年1月1日至2023年12月31日福建省福能集团总医院心理门诊诊治的儿童和青少年抑郁障碍患者的人口学特征、用药品种、治疗方案及不良反应等。结果共收集2 550例儿童和青少年抑郁障碍患者用药处方,涉及14 597张西药处方,共46 583条用药信息。16~18岁人数明显大于10~12岁和13~15岁组,患者平均年龄逐年下降,女性多于男性;用量排名前5位的精神科药物依次为舍曲林、阿普唑仑、喹硫平、奥氮平和阿立哌唑;治疗方案以多种精神科药物联用（>80%）为主,主要是抗抑郁药+抗精神病药（30.81%）、抗抑郁药+抗精神病药+镇静催眠药和抗焦虑药（26.69%）。药品不良反应累及系统-器官主要有胃肠系统疾病、代谢及营养疾病、精神系统疾病等。结论门诊儿童和青少年抑郁障碍主要使用以选择性5-羟色胺再摄取抑制剂（SSRIs）类药物为主的抗抑郁药,其中舍曲林用量最大,但用量呈逐年下降趋势,治疗方案以单一抗抑郁药为主,通常与苯二氮䓬类镇静催眠药和非典型抗精神病药联合使用。

关键词: 儿童, 青少年, 抑郁障碍, 抗抑郁药, 选择性5-羟色胺再摄取抑制剂, 舍曲林, 药品不良反应

Abstract: Objective To examine the real-world clinical medications for pediatric and adolescent patients with depressive disorders, analyze the usage of drugs, and provide references for rational prescriptions. Methods The demographic characteristics, types of drugs used, treatment regimens, and adverse drug reactions among pediatric and adolescent patients with depressive disorders treated at psychological clinic of Fujian Energy General Hospital between 2019 and 2023 were analyzed. Results A total of 2 550 prescriptions for pediatric and adolescent depression patients were collected, involving 14 597 prescriptions for Western medicines and 46 583 drug entries. The majority of patients were aged 16 to 18, who far outnumbered those in groups ages 10 to 12 and 13 to 15. The average age of patients declined over time, with females outnumbering males. The five most commonly prescribed psychiatric medications were sertraline, alprazolam, quetiapine, olanzapine, and aripiprazole. The treatment approach primarily involved polypharmacy (more than 80%), with the most common regimens being antidepressant + antipsychotic (30.81%), and antidepressant + antipsychotic + sedative-hypnotic or anxiolytic (26.69%). Adverse drug reactions included gastrointestinal disorders, metabolic and nutritional disturbances, and psychiatric symptoms. Conclusion Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are the mainstay of treatments for pediatric and adolescent depression in outpatient settings. Sertraline is the most commonly prescribed despite its declining usage. The typical treatment regimen involves a single antidepressant, often combined with benzodiazepine sedative-hypnotics and atypical antipsychotics.

Key words: Children, Adolescents, Depressive Disorders, Antidepressant, Serotonin-Selective Reuptake Inhibitors(SSRIs), Sertraline, Adverse Drug Reactions

中图分类号:

R971
R994.11

张龙瑛, 楼莉峰, 游倩, 魏语冰, 蔡艳, 李斌. 儿童和青少年抑郁障碍用药处方趋势及不良反应分析[J]. 中国药物警戒, 2024, 21(12): 1419-1424.

ZHANG Longying, LOU Lifeng, YOU Qian, WEI Yubing, CAI Yan, LI Bin. Medications and Adverse Reaction in Children and Adolescents with Depressive Disorders[J]. Chinese Journal of Pharmacovigilance, 2024, 21(12): 1419-1424.

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