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DOI: 10.1055/s-2005-862666
Psychotropic Drug Use in Psychiatric Inpatients: Recent Trends in Dosage and Choice of Psychotropic Drug in 3 German Speaking Countries
Background: Over the last decade a considerable amount of new psychotropic drugs were introduced in Europe, broadening the spectrum of available pharmacological treatment regimes in Psychiatry. As yet data on the use of these new agents and treatment choices are scarce.
The AMSP study (Arzneimittelsicherheit in der Psychiatrie) is a drug safety program for the assessment of severe adverse drug reactions in psychiatric inpatients, which was originated in 1993. Since 2001 45 psychiatric hospitals in 3 different countries (Austria, Germany, Switzerland) are participating in this program.
Methods: On two reference dates per hospital in 2003 the complete medication of all inward patients was documented as well as ICD-diagnosis, age, sex and dosage.
Results: The data from the two reference dates of 2003 included 5640 patients; 483 in Austria, 3889 in Germany, and 1268 in Switzerland. The majority of the Austrian inpatient population had an affective disorder in contrast to the other two countries, where schizophrenia was the most common psychiatric disease.
In all three countries atypical antipsychotics are treatment of first choice in schizophrenic inpatients. Although in Austria inpatients of this group were mainly being treated with Risperidon, in Germany was Olanzapine and in Switzerland Clozapine the most common prescribed agent.
In the group of depressive inpatients in Austria and Germany the majority was on a dual serotonin and noradrenergic working agent contrary to Switzerland, where the majority was on a selective serotonin reuptake inhibitor (SSRIs).
Conclusion: Although in each of the three countries atypical antipsychotics are treatment of first choice in schizophrenic inpatients, differences regarding the treatment agent were shown. In depressive inpatients a trend in using dual working antidepressants was in two of the three countries found. Further differences regarding dosage and combination of agents show how vital consensus statements regarding the psychotropic drug treatment of psychiatric diseases are.