Descriptive analysis of the use of atypical antipsychotics under compassionate-use in a health area in Ferrol (La Coruna, Spain)

作者：Santos Garcia D^*; Macias M; Casas Martinez A; Llaneza M; Abella J; Aneiros A; Santos H; Dominguez Urbistondo G; Salazar Laya B

来源：Neurologia, 2010, 25(5): 300-308.

DOI：10.1016/j.nrl.2010.01.005

• Agitation
• Anti-psychotic
• Behaviour
• Dementia
• Neuroleptic drugs
• Quetiapine

Background and objective: Although atypical antipsychotics (AA) provoke fewer extrapyramidal symptoms (ES) than classic antipsychotics, their use in patients greater than or equal to 75 years old with dementia must be under compassionate-use. This is an important limitation. We performed a descriptive analysis of the use of atypical antipsychotics under compassionate-use (AACU) in the Ferrol health area.
Patients and methods: We retrospectively assessed all the patients who were receiving an AACU from March, 2004 (that is the date when prescription under compassionate-use of AA came into force in Spain) to November 30, 2008.
Results: One hundred and thirty-three of 164 patients (63.6% women; median ages, 81.9 +/- 4.95 years) were included. Diagnostic aetiologies were: 42.9% Alzheimer's disease, 30.8% Parkinson-dementia/Lewy body disease, and 15.8% vascular/mixed dementia. A total of 68.4% of patients had received other anti-psychotic drugs previously and 32.3% had ES due to antipsychotics. The AACU received were: quetiapine (76.7%), ziprasidone (18.8%), and olanzapine (4.5%). Median follow-up time was 20.25 +/- 20.38 months. Side effects were observed in 19.7% of patients. Improvement of NPI (Neuropsychiatric Inventory) was 33.3 +/- 24.75 points. Agitation/aggressiveness (5.6 +/- 4.55), delirious ideas (4.94 +/- 5.07), irritability (4.38 +/- 4.94), and anxiety (4.32 +/- 4.83) were the symptoms that most improved. Although there were no differences between AACU, quetiapine was associated with significant maintenance in monotherapy (94.1% vs 72% for ziprasidone and 83.3% for olanzapine; p < 0.0001).
Conclusions: AACU are effective and well tolerated drugs. Quetiapine was the most frequently used AACU. An excessive percentage of patients previously received other antipsychotics and present with ES.

• 出版日期2010-6