정신과 입원환자에서 항우울제 처방경향과 그에 미치는 요인

Abstract

ABSTRACT

The patterns of antidepressant prescription and associated factors in psychiatric inpatient

Ryu Kwon-Ho Advisor : Prof. Park Sang-Hag M.D. Ph.D Department of Medicine, Graduate School of Chosun University

Objectives Prescription patterns have changed rapidly due to the development of new drugs, results of new researches, and increment of clinician’ experience. The goal of this study was to examine the trend of antidepressant prescription patterns and associating factors at a university hospital.

Methods This study evaluated the medication usage of psychiatric inpatients for two years, 2008 and 2009, including antidepressants used as the first choice, switching, and combination, and various augmentation agents. And we evaluated the factor associated with choice of antidepressant for two years, 2008 and 2009.

Results The antidepressants used as first line drug were SSRIs(51.4%), NaSSA(21.7%), SNRIs(13.8%) in frequency order. The antidepressants used as switching drug were SNRIs(35.7%), NaSSA(28.6%), and SSRIs(21.4%). As combination treatment, various combination were used including NaSSA, TCAs, SNRIs (29.4%, 29.4%, 20.6%, respectively). As augmentation treatment, atypical antipsychotics(44.2%) more used frequently than trazodone(38.4%), mood stabilizer(16.3%). The factor associated with choice of antidepressant were not different significantly. The antidepressants used as first line drug were SSRIs(51.9%), NaSSA(25.9%), SNRIs(11.1%), in frequency order in major depressive disorder. And SSRIs(74.2%), NaSSA(16.1%) were used as first line drug in Anxiety disroder and SSRIs(37.7%), SNRIs(22.6%), NaSSA(20.8%) were frequently used in other psychiatric disorder. In most cases, SSRI and mirtazapine were prescribed in other associated factor.

Conclusion The results of the present study show patterns of antidepressant prescription for two years, 2008 and 2009. Especially, psychiatrist prefer combination medication to switching antidepressant. These changes could be seen in use of various antidepressants, increment in use of atypical antipsychotics. The result of the present study that there was no significant factor associated with choice of antidepressant in ociated with choice of. It mean that clinical past experience is more important than clinical research and other associating factors in clinical situation. This study can reflect not only the current progress of psychopharmacology and clinical experience, but also the clinical complexity of prescription of antidepressant.

Key words : Antidepressant, Prescription pattern, Associated factor