Author/Editor		Drinovec, Jože; Ivanuša, Marijan; Pečar, Milka
Title		Farmakoepidemiološki in farmakoekonomski vidiki zdravljenja duševnih bolezni
Translated title		Pharmacoepidemiologic and pharmacoeconomic aspects of mental illness treatment
Type		članek
Source		Farm Vestn
Vol. and No.		Letnik 51, št. Spec issue
Publication year		2000
Volume		str. 215-21
Language		slo
Abstract		Well-conducted prospective studies investigating drug therapy in patients with mental disorders have only become available in the past ten years. In this medical area, the criteria for evaluating drug efficacy are much more complicated as those used in somatic diseases. The consumption of the most important drug groups with CNS effects, especially antidepressants, is rapidly increasing worldwide as well as in our country. The authors of this article conducted an investigation into the most common mental disorders: anxiety disorders, depressive disorders and schizophrenia. Anxiety disorders are of common occurrence; they may be short lasting and caused by a number of drugs. Manifestations of anxiety are interlaced with symptoms of depression. In the past anxiety disorders were most often treated with benzodiazepines, while in the last decade also antidepressants have been introduced into therapy. One out of 8 people experiences depressive disorders during his lifetime. A severe depressive disorder may lead to a suicidal action and is associated with other mental and somatic diseases. The most commonly prescribed drug groups used for the management of depressive disorders include tricyclic antidepressants and serotonin re-uptake inhibitors. While similar efficacy has been demonstrated for both groups of drugs, the group of serotonin re-uptake inhibitors has been shown to be associated with better tolerability. Schizofrenia afflicts only 1% of the population, but it is associated with a high degree of debilitation of the patient and an unproportionately great social impact. Schizophrenia requires frequent and long-lasting hospitalization: it reduces the patients normal functioning in his environment, his productivity and decreases his quality of life. The cost of drug therapy accounts for no more than 5% of the total expenses involved in the treatment of schizophrenia.
Summary		Pri zdravljenju bolnikov z duševnimi motnjami so na voljo dobre prospektivne raziskave z zdravili šele v zadnjem desetletju. Merila za učinkovitost zdravil so bolj zapletena kot pri zdravljenju somatskih bolezni. Poraba najpomembnejših skupin zdravil z učinkom na osrednje živčevje, še posebej antidepresivov, v svetu in tudi pri nas hitro narašča. Avtorji so proučili najpogostejše bolezenske skupine med duševnimi boleznimi: anksiozne motnje, depresivne motnje in shizofrenijo. Anksiozne motnje se javljajo pogosto, so lahko kratkotrajne, povzročajo jih številna zdravila. Njihova manifestacija se prepleta z depresivnimi motnjami. V preteklosti so pri zdravljenju anksioznih motenj najpogosteje uporabljali benzodiazepine, v zadnjem desetletju tudi protidepresivna sredstva. Depresivne motnje se tekom življenja javljajo pri 1 od 8 ljudi. V hujši obliki lahko vodijo do samomora in so povezane z drugimi psihičnimi in telesnimi boleznimi. Najpogostejši skupini zdravil, ki se uporabljata pri depresivnih motnjah, so triciklična protidepresivna sredstva in zaviralci prevzema serotonina. Učinkovitost je podobna, prenosljivost pa je večja pri inhibitorjih serotoninskega prevzema. Shizofrenija prizadeva le 1% prebivalstva, osebna prizadetost in družbena škoda bolezni pa je nesorazmerno velika. Bolezen zahteva pogosto in dolgotrajno hospitalizacijo, zmanjšuje bolnikove stike z okoljem, njegovo produktivnost, kakovost življenja. Zdravljenje z zdravili pomeni le 5% celotnih stroškov za zdravljenje bolnikov za shizofrenijo.
Descriptors		MENTAL DISORDERS ANTIDEPRESSIVE AGENTS SEROTONIN UPTAKE INHIBITORS DEPRESSIVE DISORDER ANXIETY DISORDERS SCHIZOPHRENIA DRUG COSTS PHARMACOEPIDEMIOLOGY