老年族群服用抗憂鬱劑之處方型態分析：某精神專科醫院三年回溯性分析

目的:瞭解老年憂鬱症病人使用抗憂鬱劑之處方型態，包括抗憂鬱劑之處方比例、使用劑量及多重用藥之使用情況等。方法:本研究為回溯性分析研究，篩選自2011年至2013年間於某精神專科醫院門診就醫資料，服用抗憂鬱劑且年齡大於65歲以上之病人。結果:共收入721位病人，其中女性病人約為男性之1.5倍。藥品以trazodone處方比率21.4%最高，其次依序為escitalopram、sertraline、duloxetine、mirtazapine、paroxetine、citalopram。各抗憂鬱劑之被處方次數各年度間之差異皆未達統計學上之意義。各組抗憂鬱劑較常出現之疾病皆為精神官能性憂鬱症(lCD-9 300.4)。服用selective serotonin reuptake inhibitor(SSRI)和serotonin-norepi-nephrine reuptake inhibitor(SNRI)類抗憂鬱劑者大部分為精神官能性憂鬱症和重鬱症患者(lCD-9 296.2、296.3)。結論:除了fluoxetine、paroxetine及duloxetine外，其餘藥品之平均日劑量皆小於WHO建議之日劑量。約有1/3的病人持續服用相同抗憂鬱劑達2年以上。精神專科醫師還用抗憂鬱劑時不因性別不同而所有差異。

關鍵字

抗憂鬱劑；老年憂鬱症；處方型態

並列摘要

Objectives. The aim of this study was to know outpatients'prescription patterns of antidepressants for elderly patients. Methods. This retrospective study examined the use of antidepressants in depressive elderly patients during 2011 to 2013. 721 patients (60.6% females) above 65 years old were recruited from the outpatient department of a psychiatric center in central Taiwan. . Results. Results show that the number of female patients were about 1.5 times more than that of men. The most frequent antidepressant prescribed to the elderly patients was trazodone (21.4%), followed by escitalopram, sertraline, duloxetine, mirtazapine, paroxetine, and citalopram. There was no significant difference in the annual prescribed amounts of these antidepressants. Dysthymic disorder was the most frequent disorder treated with antidepressants. Subjects using selective serotonin reuptake inhibitors and serotoninnorepinephrine reuptake inhibitors had higher proportions of neurotic depression and major depressive disorders. Conclusion. Apart from fluoxetine, paroxetine, and duloxetine, the average daily doses of antidepressants were below the WHO recommendation. One-third of elderly patients were prescribed the same antidepressants for more than two years. There was no gender difference in what antidepressants were being prescribed.

並列關鍵字

Antidepressants ； Elderly depression ； Prescribed patterns

參考文獻

內政部統計處：103年第3週內政統計通報。http://www.moi.gov.tw/stat/news_content.aspx?sn=8057引用11/2/2015。 Department of Statistics, Ministry of the Interior (Taiwan, ROC): Week 3, 2014 Statistical Book of Interior. Available at: http://www.moi.gov.tw/stat/news_content.aspx?sn=8057. Accessed November 2, 2015. [In Chinese]