2015年上海市同济医院门诊抗抑郁药物的使用情况分析

目的：分析上海市同济医院门诊抗抑郁药使用情况和趋势，为临床合理用药提供参考。方法通过HIS系统查询上海市同济医院2015年门诊抗抑郁药的使用情况，采用世界卫生组织推荐的限定日剂量为指标的分析方法，对上海市同济医院2015年门诊抗抑郁药的品种、销售金额、用药频度（DDDs）和限定日费用（DDC）进行统计分析。结果销售金额排序前3位的分别是艾司西酞普兰、帕罗西汀、文拉法辛。DDDs排名前4位的分别为帕罗西汀、文拉法辛、艾司西酞普兰和西酞普兰，金额排序/DDDs排序除艾司西酞普兰、帕罗西汀外均在0.80～1.50。DDC排序前3位的分别是度洛西汀、艾司西酞普兰、西酞普兰。结论上海市同济医院2015年门诊抗抑郁药使用基本合理，其中选择性5-羟色胺再摄取抑制剂成为一线抗抑郁药，新型抗抑郁药艾司西酞普兰异军突起，但费用较高，其应用情况值得商榷。

Analysis on usage of antidepressants in outpatient of Shanghai Tongji Hospital in 2015

Objective To analyze the usage and trend of antidepressants in outpatient of Shanghai Tongji Hospital, so as to provide references for clinical rational drug use. Methods The usage of antidepressants in outpatient of Shanghai Tongji Hospital was calculated by HS system, and the World Health Organization recommended daily dose was defined as index method of analysis. Antidepressants, consumption sum, defined daily dose system (DDDs), and defined daily costs (DDC) were calculated and analyzed. Results Consumption sums of escitalopram, paroxetine, and venlafaxine ranked top 3. DDDs of paroxetine, venlafaxine, escitalopram, and escitalopram ranked the top 4. Consumption sum ranks/DDDs ranks of antidepressants except escitalopram and paroxetine were between 0.80 and 1.50. DDC of antidepressants ranking the top 3 were duloxetine, escitalopram, and citalopram. Conclusion The usage of antidepressants in outpatient of Shanghai Tongji Hospital is reasonable, and selective serotonin reuptake inhibitors (SSRIs) become the first-line antidepressants, the new antidepressant escitalopram develops rapidly, but its application is questionable for higher cost.