The use of atypical antipsychotics in French psychiatric hospitals.
OBJECTIVE
To study the prescribing practices of atypical antipsychotic drugs in French psychiatric hospitals.


METHODS
A 1-day cross-sectional observational survey was performed in seven psychiatric hospitals to study prescribing practices of the four atypical antipsychotics (AAP) marketed in France. These hospitals are members of the PIC network, a pharmacists' working group based in southwestern France.


METHODS
Type and dosages of prescribed atypical antipsychotics, indication and concomitant prescriptions.


RESULTS
The study included 1475 adult inpatients' prescriptions with an antipsychotic drug; 647 prescriptions included an AAP with risperidone and olanzapine accounting for about 70% cases. AAP prescriptions concerned psychotic patients in 65% of cases. Patients receiving an AAP in this indication were more likely to be male, were younger, and received higher daily doses than patients treated for other troubles. They were also more likely to receive associated neuroleptic and anticholinergic antiparkinsonian agents. There were 59 prescriptions (9.1%) for bipolar disorders. Clozapine wasn't used in this indication. In 76.3% of cases, mood stabilizers were associated to the AAP prescribed in this indication.


CONCLUSIONS
This observational survey underlines the significant place taken by AAP for the treatment of psychiatric diseases in hospital prescribing practices. They show usage patterns of these drugs: dose, indications and concomitant medications, in line or not with current recommendations and reference guidelines. In bipolar disorders, AAPs seem more likely to be associated to an ongoing therapy using mood stabilizer than to replace it.
Bret
Marie Christine
MC
Department of Pharmacy, Centre Hospitalier Charles Perrens, 121 Avenue de la Béchade, 33076, Bordeaux cedex, France. mcbret@ch-perrens.fr
Bret
Pierre
P
Pariente
Antoine
A
Fourier-Réglat
Annie
A
D000328:Adult; D000367:Age Factors; D000077582:Amisulpride; D018692:Antimanic Agents / Q000627:therapeutic use; D000978:Antiparkinson Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy; D003024:Clozapine / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005602:France; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D008875:Middle Aged; D000077152:Olanzapine; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000188:drug therapy; D018967:Risperidone / Q000627:therapeutic use; D012737:Sex Factors; D013469:Sulpiride / Q000031:analogs & derivatives / Q000627:therapeutic use
D018692:Antimanic Agents; D000978:Antiparkinson Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D013469:Sulpiride; D000077582:Amisulpride; D003024:Clozapine; D018967:Risperidone; D000077152:Olanzapine