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
Waldemar Greil, Mateo de Bardeci, Johanna Seifert, Xueqiong Bernegger, Katja Cattapan, Hans Stassen, Anita L. Wagner, Marcel Sieberer, Renate Grohmann, Sermin Toto
{"title":"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","authors":"Waldemar Greil, Mateo de Bardeci, Johanna Seifert, Xueqiong Bernegger, Katja Cattapan, Hans Stassen, Anita L. Wagner, Marcel Sieberer, Renate Grohmann, Sermin Toto","doi":"10.1002/hup.2809","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":13030,"journal":{"name":"Human Psychopharmacology: Clinical and Experimental","volume":"37 1","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/hup.2809","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Human Psychopharmacology: Clinical and Experimental","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hup.2809","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
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.
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