Treatment of depression: Are psychotropic drugs appropriately dosed in women and in the elderly? Dosages of psychotropic drugs by sex and age in routine clinical practice

IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY
Waldemar Greil, Mateo de Bardeci, Johanna Seifert, Xueqiong Bernegger, Katja Cattapan, Hans Stassen, Anita L. Wagner, Marcel Sieberer, Renate Grohmann, Sermin Toto
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引用次数: 2

Abstract

Background

Several researchers have shown higher concentration-dose ratios of psychotropic drugs in women and the elderly. Therefore, lower dosages of psychotropic drugs may be recommended in women and the elderly. This study describes sex- and age-related dosage of psychotropic drugs prescribed to patients with major depressive disorder (MDD) in routine clinical practice.

Method

Influence of sex and age on dosages are analysed for the 10 most commonly prescribed drugs in our dataset consisting of 32,082 inpatients with MDD. Data stems from the European drug safety program “Arzneimittelsicherheit in der Psychiatrie”. The observed sex and age differences in prescriptions are compared to differences described in literature on age- and gender-related pharmacokinetics.

Results

Among patients over 65 years, a statistically significant decrease in dosages with increasing age (between 0.65% and 2.83% for each increasing year of age) was observed, except for zopiclone. However, only slight or no influence of sex-related adjustment of dosage in prescriptions was found.

Conclusion

Age appears to influence adjustment of dosage in most psychotropic drugs, but to a lower extent than data on age-related pharmacokinetics suggests. Although literature also suggests that lower dosages of psychotropic drugs may be appropriate for females, this study found women are usually prescribed the same dosage as men.

Abstract Image

抑郁症的治疗:精神药物对女性和老年人的剂量是否合适?日常临床实践中按性别、年龄划分的精神药物剂量
一些研究人员发现精神药物在女性和老年人中有较高的浓度剂量比。因此,建议妇女和老年人服用低剂量的精神药物。本研究描述了重度抑郁症(MDD)患者在常规临床实践中精神药物处方剂量与性别和年龄的关系。方法分析了性别和年龄对10种最常用处方药剂量的影响,该数据集包括32,082名MDD住院患者。数据来源于欧洲药物安全项目“精神病学研究”。在处方中观察到的性别和年龄差异与年龄和性别相关药代动力学文献中描述的差异进行了比较。结果在65岁以上的患者中,除佐匹克隆外,用药剂量随年龄的增加而下降(每增加一岁,用药剂量下降0.65% ~ 2.83%),具有统计学意义。然而,处方中剂量的性别调整仅轻微或没有影响。结论年龄似乎会影响大多数精神药物的剂量调整,但影响程度低于年龄相关药代动力学数据。虽然文献也表明,较低剂量的精神药物可能适合女性,但这项研究发现,女性的处方剂量通常与男性相同。
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来源期刊
CiteScore
4.10
自引率
0.00%
发文量
34
审稿时长
6-12 weeks
期刊介绍: Human Psychopharmacology: Clinical and Experimental provides a forum for the evaluation of clinical and experimental research on both new and established psychotropic medicines. Experimental studies of other centrally active drugs, including herbal products, in clinical, social and psychological contexts, as well as clinical/scientific papers on drugs of abuse and drug dependency will also be considered. While the primary purpose of the Journal is to publish the results of clinical research, the results of animal studies relevant to human psychopharmacology are welcome. The following topics are of special interest to the editors and readers of the Journal: -All aspects of clinical psychopharmacology- Efficacy and safety studies of novel and standard psychotropic drugs- Studies of the adverse effects of psychotropic drugs- Effects of psychotropic drugs on normal physiological processes- Geriatric and paediatric psychopharmacology- Ethical and psychosocial aspects of drug use and misuse- Psychopharmacological aspects of sleep and chronobiology- Neuroimaging and psychoactive drugs- Phytopharmacology and psychoactive substances- Drug treatment of neurological disorders- Mechanisms of action of psychotropic drugs- Ethnopsychopharmacology- Pharmacogenetic aspects of mental illness and drug response- Psychometrics: psychopharmacological methods and experimental design
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