Twenty-Three Years of Declining Lithium Use: Analysis of a Pharmacoepidemiological Dataset from German-Speaking Countries.

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pharmacopsychiatry Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI:10.1055/a-2374-2386

Waldemar Greil, Mateo de Bardeci, Nadja Nievergelt, Sermin Toto, Renate Grohmann, Johanna Seifert, Georgios Schoretsanitis

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引用次数: 0

Abstract

Introduction: Pharmacoepidemiological data suggest that lithium prescriptions for bipolar disorder are gradually decreasing, with less attention having been paid to other indications.

Methods: We examined lithium prescriptions between 1994 and 2017 in data provided by the Drug Safety in Psychiatry Program AMSP, including psychiatric hospitals in Germany, Austria and Switzerland. We compared lithium use for different diagnoses before and after 2001 and in three periods (T1: 1994-2001, T2: 2002-2009, and T3: 2010-2017).

Results: In a total of 158,384 adult inpatients (54% female, mean age 47.4±17.0 years), we observed a statistically significant decrease in lithium prescriptions between 1994-2000 and 2001-2017 in patients with schizophrenia spectrum disorder from 7.7% to 5.1% and in patients with affective disorders from 16.8% to 9.6%. Decreases in use were also observed for diagnostic subgroups: schizoaffective disorder (ICD-10 F25: 27.8% to 17.4%), bipolar disorder (F31: 41.3% to 31%), depressive episode (F32: 8.1% to 3.4%), recurrent depression (F33: 17.9% to 7.5%, all: p<0.001) and emotionally unstable (borderline) personality disorder (6.3% to 3.9%, p=0.01). The results in T1 vs. T2 vs. T3 were for F25: 26.7% vs. 18.2% vs. 16.2%, F32: 7.7% vs. 4.2% vs. 2.7%, F33: 17.2% vs. 8.6% vs. 6.6% and for F31: 40.8% vs. 31.7% vs 30.0%, i. e. there was no further decrease for lithium use in bipolar disorder after 2002. Lithium's main psychotropic co-medications were quetiapine (21.1%), lorazepam (20.6%), and olanzapine (15.2%).

Discussion: In inpatients, the use of lithium has decreased in patients with bipolar disorder and also with various other psychiatric diagnoses.

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二十三年来锂的使用量不断下降：德语国家药物流行病学数据集分析》。

引言药物流行病学数据表明，用于治疗双相情感障碍的锂处方正在逐渐减少，而对其他适应症的关注则较少：我们根据精神病学药物安全项目 AMSP（包括德国、奥地利和瑞士的精神病院）提供的数据，研究了 1994 年至 2017 年期间的锂处方。我们比较了 2001 年前后三个时期（T1：1994-2001 年；T2：2002-2009 年；T3：2010-2017 年）不同诊断的锂使用情况：在总共 158384 名成年住院患者（54% 为女性，平均年龄为 47.4±17.0 岁）中，我们观察到在 1994-2000 年和 2001-2017 年间，精神分裂症谱系障碍患者的锂处方从 7.7% 降至 5.1%，情感障碍患者的锂处方从 16.8% 降至 9.6%，降幅具有统计学意义。在以下诊断亚组中也观察到了使用量的减少：分裂情感障碍（ICD-10 F25：27.8%降至17.4%）、双相情感障碍（F31：41.3%降至31%）、抑郁发作（F32：8.1%降至3.4%）、复发性抑郁（F33：17.9%降至7.5%，均为 "讨论"：在住院病人中，双相情感障碍和其他各种精神疾病患者使用锂的情况有所减少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacopsychiatry 医学-精神病学

CiteScore

7.10

自引率

9.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Covering advances in the fi eld of psychotropic drugs, Pharmaco psychiatry provides psychiatrists, neuroscientists and clinicians with key clinical insights and describes new avenues of research and treatment. The pharmacological and neurobiological bases of psychiatric disorders are discussed by presenting clinical and experimental research.