Prescribing patterns in patients with obsessive-compulsive disorder: Retrospective, single-center study

IF 1.8 4区 医学 Q3 CLINICAL NEUROLOGY Human Psychopharmacology: Clinical and Experimental Pub Date : 2024-05-11 DOI:10.1002/hup.2900
Joshua Knebel, M. Lindsey Hedgepeth Kennedy
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Abstract

Introduction

Obsessive-compulsive disorder (OCD) is marked by a high rate of treatment resistance. Patients are often left trialing medications within multiple drug classes with little response, causing heterogeneity to emerge in prescribing patterns. This analysis seeks to investigate the selection and dosing of the pharmacotherapy utilized, to portray an overview of prescribing trends in the United States.

Methods

This retrospective, single center, review of electronic medical records investigated the pharmacotherapy utilization of patients with a primary diagnosis of OCD. Two hundred and ninety-five patients who received OCD treatment at an urban, academic medical center were included in the study. Patients were included in the review if they were at least eighteen years of age and were assigned a diagnosis of OCD according to DSM-5 criteria.

Results

Psychotropic pharmacotherapy was integrated into the care of 93% of patients. Selective serotonin reuptake inhibitors were the most utilized medication class at 85% followed by benzodiazepines (47%) and second-generation antipsychotics (37%). Tricyclic antidepressants and first-generation antipsychotics were the two medication classes utilized the least at 13% and 2% respectively. Additionally, mood stabilizers and serotonin-norepinephrine reuptake inhibitors were utilized at rates of 8% and 16%, respectively.

Conclusions

Evidence-based treatment guidelines are being followed with varying augmentation strategies widely prevalent, thus displaying the heterogeneity in treating OCD. A high rate of benzodiazepine utilization highlights a practice trend with potential ties to clinical factors, such as the latency to treatment effect of other first-line pharmacotherapies. Future prospective studies are required to determine the cultural, pharmacoeconomic and pharmacogenomic factors that contribute to the variation in prescribing practices and whether these variations influence treatment outcomes.

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强迫症患者的处方模式:回顾性单中心研究。
简介强迫症(OCD)的显著特点是抗药性高。患者在尝试多种药物治疗后往往收效甚微,从而导致处方模式出现异质性。本分析旨在调查所使用的药物疗法的选择和剂量,以概述美国的处方趋势:这项回顾性的单中心电子病历研究调查了主要诊断为强迫症的患者对药物疗法的使用情况。研究对象包括在一家城市学术医疗中心接受强迫症治疗的 295 名患者。根据 DSM-5 诊断标准,年满 18 周岁且被诊断为强迫症的患者均被纳入审查范围:93%的患者接受了精神药物治疗。选择性血清素再摄取抑制剂是使用率最高的药物类别,占 85%,其次是苯二氮卓(47%)和第二代抗精神病药物(37%)。三环类抗抑郁药和第一代抗精神病药是使用率最低的两类药物,分别为 13% 和 2%。此外,情绪稳定剂和血清素-去甲肾上腺素再摄取抑制剂的使用率分别为8%和16%:结论:在遵循循证治疗指南的同时,不同的增效策略也普遍存在,这显示了强迫症治疗的异质性。苯二氮卓类药物的高使用率凸显了一种实践趋势,这种趋势可能与临床因素有关,如其他一线药物疗法的治疗效果潜伏期。未来需要进行前瞻性研究,以确定导致处方做法差异的文化、药物经济学和药物基因组学因素,以及这些差异是否会影响治疗结果。
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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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