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Polifarmacia en el tratamiento psiquiátrico. Patrones de uso de los fármacos psicotropos en clínicas psiquiátricas austríacas
Published online by Cambridge University Press: 12 May 2020
Resumen
Hay grandes variaciones en el modo en que los fármacos psicotropos se prescriben. La mayoría de los expertos están a favor de la monoterapia psicofarmacológica, pero se sabe poco sobre el alcance de su práctica real. Se llevó a cabo un estudio de la medicación psicofarmacológica de todos los pacientes en tratamiento en tres clínicas psiquiátricas austríacas de diverso tipo en dos días distintos. Se seleccionó para el estudio una clínica universitaria psiquiátrica, el departamento psiquiátrico de un hospital general y un hospital mental regional. Se estableció que sólo de 8 a 22% de los pacientes recibían monoterapia psicofarmacológica y que les daban de 2,2 a 3,3 psicotropos como media. De 5 a 22% de los pacientes recibían cinco o más agentes psicotropos. Los resultados se presentan con más detalle en relación con los diagnósticos de esquizofrenia y depresión. La presencia poco común de la monoterapia se podría deber a regímenes de tratamiento erróneos en algunos casos, pero mucho más a una tendencia general en psiquiatría que fomenta el uso polifarmacológico.
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References
Bibliografía
Ambühl, BWürmle, OMichel, B.Die Verschreibungspraxis von Psychopharmaka in einer psychiatrischen Universitat-sklinik (Psychotropic prescribing practices in a psychiatric university hospital). Psychiatrische Praxis 1993; 20: 70–3.Google Scholar
American Psychiatric Association. Practice guidelines for the treatment of patients with bipolar disorder. Am J Psychiatry 1994; 151: 1–36.CrossRefGoogle Scholar
Andreasen, NCBlack, DW.Lehrbuch Psychiatrie (Psychiatry textbook). Beltz: Psychologie Verlagsunion; 1993.Google Scholar
Azorin, JM.Long-term treatment of mood disorders in schizophrenia. Acta Psychiatr Scand 1995; 91 suppl 388: 20–3.CrossRefGoogle Scholar
Baldessarini, RJViguera, AC. Neuroleptic withdrawal in schizophrenic patients. Arch Gen Psychiatry 1995; 52: 189–22.CrossRefGoogle ScholarPubMed
Buckley, PFMeltzer, HY. Treatment of schizophrenia. In: Schazberg, AFNemeroff, CB, eds. The American psychiatric textbook of psychopharmacology. Washington: American Psychiatric Press; 1995. p. 236–51.Google Scholar
Clark, AFHolden, NL. The persistence of prescribing habits: a survey and follow-up of prescribing to chronic hospital in-patients. Brit J Psychiatry 1987; 150: 88–91.CrossRefGoogle ScholarPubMed
Collins, EJHogan, TPAwad, AG. The pharmacoepidemiology of treatment-refractory schizophrenia. Can J Psychiatry 1992; 37: 192–5.CrossRefGoogle ScholarPubMed
Craig, TJBehar, R.Trends in the prescription of psychotropic drugs (1970-77) in a State hospital. Comprehensive Psychiatry 1980; 21: 336–45.CrossRefGoogle Scholar
Denicoff, KDMeglathery, SBPost, RMTandeciarz, SI. Efficacy of carbamazepine compared with other agents: a clinical practice survey. J Clin Psychiatry 1994; 55:70–6.Google ScholarPubMed
Edwards, SKumar, VA. Survey of prescribing of psychotropic drugs in a Birmingham psychiatric hospital. Brit J Psychiatry 1984; 145: 502–7.CrossRefGoogle Scholar
Famuyiwa, OO. Psychotropic drug prescription in Nigeria. Acta Psychiatr Scand 1983; 68: 73–81.CrossRefGoogle ScholarPubMed
Francés, ADocherty, JPKahn, DA. The expert consensus guideline series. Treatment of bipolar disorder. J Clin Psychiatry 1996; 57 suppl 12A: 5–88.Google Scholar
Grohmann, RStrauss, AGehr, CRüther, EHippius, H.Zur Praxis der klinischen Therapie mit Psychopharmaka. Retrospektive Untersuchung der Verordnungsgewohn-heiten in einer Psychiatrischen Universitasklinik (On clinical therapy practice with psychotropics. Retrospective survey of prescribing patterns in a psychiatric university hospital). Pharmakopsychiat 1980; 13: 1–19.Google Scholar
Haag, HRüther, EHippius, H.Tardive dyskinesia. WHO expert series on biological psychiatry, Vol. 1. Seattle: Hogrefe & Huber; 1992.Google Scholar
Haase, HJ. Therapie mit Psychopharmaka und anderen psychotropen Medikamenten (Therapy with psycho-pharmacological agents and other psychotropic drugs). Stuttgart, New York: Schattauer; 1972.Google Scholar
Hemminki, E.Polypharmacy among psychiatric patients. Acta Psychiatr Scand 1977; 56: 347–56.CrossRefGoogle ScholarPubMed
Holloway, F.Prescribing for the long-term mentally ill. A study of treatment practices. Brit J Psychiatry 1988; 152: 511–15.CrossRefGoogle ScholarPubMed
Janicak, PGDavis, JMPreskorn, SHAyd, FJ. Principies and practice of psychopharmacotherapy. Baltimore: Williams & Wilkins; 1993.Google Scholar
Kane, JM. Neuroleptic treatment in schizophrenia. In: Nasrallah, HA, ed. Handbook of schizophrenia, vol. 2. Amsterdam: Elsevier; 1987. p. 179–202.Google Scholar
Kapur, SRemington, GJones, Cet al. High levels of dopamine D2 receptor occupancy with low-dose haloperidol treatment: a PET study. Am J Psychiatry 1996; 153: 948–50.Google ScholarPubMed
Klein, HERüther, EStaedt, J.Kombinierte Psychophar-makatherapie einschlieplich Behandlung chronischer sch-merzsyndrome (Combined psychotropic therapy including treatment of chronic pain syndromes). In: Rieder, PLaux, GPoldinger, W, eds. Neuropsycohpharmaka. Vienna: Springer; 1992. p. 425–58.Google Scholar
König, WKunow, JKniehl, RReimer, F.Neuroleptics in the treatment of schizophrenia: have there been changes in the dosage regimen? Pharmacopsychiat 1986; 19: 212–3.CrossRefGoogle Scholar
Krakowski, MIKunz, MCzobor, PVolvavka, J.Long-term high-dose neuroleptic treatment: who gets it and why? Hosp Commun Psychiatry 1993; 44: 640–4.Google Scholar
Kramer, MSVogel, WHDijohnson, CDewey, DASheves, PCaviccia, Set al.Antidepressants in depressed schizophrenic in-patients. Arch Gen Psychiatry 1989; 46: 922–8.CrossRefGoogle Scholar
Laux, G.Aktueller Stand der Behandlung mit Benzodiazepinen (Current State of treatment with benzodiazepines). Nervenarzt 1995; 66: 311–22.Google Scholar
Lipton, AA, Cancro R. Schizophrenia: clinical features. In: Kaplan, HISadock, BJ, eds. Comprehensive textbook of psychiatry VI. Baltimore: Williams & Wilkins; 1995. p. 968–87.Google Scholar
Mason, AS. Basic principies in the use of antipsychotic agents. Hospital Community Psychiatry 1973; 24: 825–89.Google Scholar
Mason, ASNerviano, VDeBurger, RA: Patterns of antipsychotic drug use in four southeastern State hospital. Dis Nerv System 1977; 38: 541–7.Google Scholar
McEvoy, JPHogarty, GESteingard, S.Optimal dose of neuroleptic in acute schizophrenia. A controlled study of the neuroleptic threshold and higher haloperidol dose. Arch Gen Psychiatry 1991; 48: 739–55.CrossRefGoogle ScholarPubMed
Michel, KKolakowska, T.A survey of prescribing of psychotropic drugs in two psychiatric hospitals. Brit J Psychiat 1981; 138: 217–21.CrossRefGoogle ScholarPubMed
Miller, NSGold, MS. Abuse, addiction tolerance and dependence to benzodiazepines in medical and nonmedical populations. Am J Drug Alcohol Abuse 1991; 17: 27–37.CrossRefGoogle ScholarPubMed
Mohr, FHubmann, WBender, W.Niedrigdosierte Neuroleptikatherapie - Praxis in der psychiatrischen Akutversorgung? (Low-dosage neuroleptic therapy-practice in psychiatric acute treatment). In: Hofmann, PKulhanek, FMelisch, BZapotocky, HG, eds. I. Graz: Conventum Psychiatricum Internationale; 1991.Google Scholar
Morgan, RGopalaswamy, AK. Psychotropic drugs: another survey of prescribing patterns. Brit J Psychiatry 1984; 144: 298–302.CrossRefGoogle ScholarPubMed
Muijen, MSilverstone, T.A comparative hospital survey of psychotropic drug prescribing. Brit J Psychiatry 1987, 150: 501–4.CrossRefGoogle ScholarPubMed
Peralta, VCuesta, MJCaro, FMartínez-Larrea, A.Neuroleptic dose and schizophrenic symptoms. A survey of prescribing practices. Acta Psychiatr Scand 1994; 90: 354–7.CrossRefGoogle ScholarPubMed
Prien, RFBalter, MBCaffey, EM. Hospital surveys of prescribing practices with psychotherapeutic Drugs. A critical examination. Arch Gen Psychiatry 1978; 35: 1271–5.CrossRefGoogle ScholarPubMed
Reardon, GTRifkin, ASchwartz, AMyerson, ASiris, SG. Changing patterns of neuroleptic dosage over a decade. Am J Psychiatry 1989; 146: 726–9.Google ScholarPubMed
Remington, G.Pharmacotherapy of schizophrenia. Can J Psychiatry 1989; 34: 211–19.CrossRefGoogle ScholarPubMed
Remington, GPollock, B.Voineskos, GReed, KCoulter, K.Acutely psychotic patients receiving high-dose haloperidol therapy. J Clin Psychopharmacol 1993; 13: 41–5.CrossRefGoogle ScholarPubMed
Rey, MJSchulz, PCosta, CDick, PTissot, R.Guidelines for the dosage of neuroleptics. I: Chlorpromazine equivalents of orally administered neuroleptics. Int Cli Psychopharmacology 1989; 4: 95–104.CrossRefGoogle ScholarPubMed
Riffer, FHinkel, DZeyringer, RFriedl, EJ. Medikamentöse Therapiestrategien und deren Auswirkungen bei schzophrenen Patienten (Drug therapy strategies and their effects on schizophrenic patients). In: Platz, T, ed. Betroffen von Schizophrenie, Linz: Edition pro mente, 1995. p. 125–36.Google Scholar
Rittmannsberger, HSchöny, W.Praktische Durchführung allgemeine Behandlungsrichtlinien (Practical implementation, general treatment guidelines). In: Riederer, PLaux, GPöldinger, , eds. Neuropsycohpharmaka Vol. 4, Neuroleptika. Berlin: Springer; 1998. p202–25.Google Scholar
Schmidt, LGCzerlinsky, HStöckel, M.Longitudinal assessment of psychotropic drug use in acutely ill psychiatric in-patients. Int J Clin Pharmacol Ther Tox 1987; 25: 244–30.Google Scholar
Schmidt, LGLammers, VStöckel, MMüller-Oerlinghausen, B.Recent trends in prescribing psychotropic drugs at a psychiatric university hospital (1981-84). Pharmacopsychist 1988; 21: 126–30.CrossRefGoogle Scholar
Schulz, PRey, MJDick, PTissot, R.Guidelines for the dosage of neuroleptics. II: Changing from daily oral to long-acting injectable neuroleptics. Int Clinical Psychopharmacology 1989; 4: 105–14.CrossRefGoogle ScholarPubMed
Schweizer, ERickels, K.Strategies for treatment of generalized anxiety in the primary care setting. J Clin-Psychiatry 1997; 58 suppl 3: 27–31.Google ScholarPubMed
Shepard, CCollins, LFiorentino, DFracchia, JMerlis, S.Polypharmacy in psychiatric treatment. I. Incidence at a State hospital. Current Therapy Research 1969; 11: 765–74.Google Scholar
Stone, CKGarver, DLGriffith, JHirschowitz, JBennett, J.Further evidence of a dose-response threshold for haloperidol in psychosis. Am J Psychiatry 1995; 152: 1210–2.Google ScholarPubMed
Strauss, AScherer, JFriedl, FRüther, E.The importance of the quantitative description of drug therapy for drug surveillance in psychiatry. Pharmacopsychiat 1985; 18: 29–30.CrossRefGoogle Scholar
Winstead, DKBlackwell, BEilers, MK. Psychotropic drug use in five city hospitals. Dis Nerv System 1976; 37: 504–9.Google ScholarPubMed
Yosselson-Superstine, SSternik, DLiebenzon, D.Prescribing patterns in psychiatric hospitals in Israel Acta Psychiatr Scand 1979; 60: 477–82.CrossRefGoogle ScholarPubMed
Zito, JMCraig, TJWanderling, JSiegel, C.Pharmaco-epidemiology in 136 hospitalized schizophrenic patients. Am J Psychiatry 1987; 144: 778–82.Google ScholarPubMed