進階搜尋


下載電子全文  
系統識別號 U0026-1607201218221300
論文名稱(中文) 台灣小兒門診抗憂鬱劑之處方型態分析
論文名稱(英文) Prescribing pattern of antidepressants for pediatric patients in ambulatory care in Taiwan
校院名稱 成功大學
系所名稱(中) 臨床藥學與藥物科技研究所
系所名稱(英) Institute of Clinical Pharmacy and Pharmaceutical sciences
學年度 100
學期 2
出版年 101
研究生(中文) 吳承誌
研究生(英文) Cheng-Chih Wu
學號 s66981066
學位類別 碩士
語文別 中文
論文頁數 111頁
口試委員 指導教授-高雅慧
口試委員-楊延光
口試委員-李怡慧
口試委員-林嘉音
中文關鍵字 抗憂鬱劑  處方型態  兒童青少年  台灣  全民健康保險資料庫 
英文關鍵字 antidepressants  prescribing pattern  children and adolescents  Taiwan  NHIRD 
學科別分類
中文摘要 研究背景
抗憂鬱劑已被證實能有效改善憂鬱症或焦慮症等精神疾患症狀。受限於倫理因素,往往較難於兒童與青少年族群進行臨床試驗,而無法取得使用於該族群之核准適應症。各國於2003年起陸續發布的警訊指出抗憂鬱劑使用於小兒族群可能提高自殺風險。上述因素皆顯示出缺乏小兒族群使用抗憂鬱劑之療效與安全性資訊,更彰顯利用資料庫進行兒童與青少年族群的回溯研究重要性。
目前台灣使用抗憂鬱劑相關研究付之闕如,惟部分研究著眼於精神疾患盛行率或以成年人為研究對象,較難外推至兒童與青少年族群使用抗憂鬱劑之情況。因此,本研究旨在討論兒童與青少年族群之抗憂鬱劑使用之處方型態,探討其使用盛行率、各類抗憂鬱劑之比例及病患之臨床特性等議題。

研究方法
本研究利用全民健康保險資料庫進行分析,檔案擷取2006年至2007年,年齡小於18歲之兒童或青少年,以3:1的比例隨機抽樣,先行檢視2006年與2007年之盛行率。納入2006/07/01至2007/12/31於門診新使用抗憂鬱劑處方的病患,分析其第一筆處方。研究對象依其使用藥物種類分成selective serotonin reuptake inhibitors (SSRI)、serotonin norepinephrine reuptake inhibitors (SNRI)、tricyclic antidepressant (TCA)及其他 (others)等四組,分析其使用種類、臨床特性,包括人口學特徵、精神相關診斷(mental disorder)、共病症(co-morbidity)、合併使用精神藥物(psychotropic co-medication)情形、精神門診就醫次數(psychiatric visits)與住院次數(psychiatric hospitalization)、開立處方醫師專科別與醫療機構等級。
研究結果
兒童與青少年於2006年及2007年使用抗憂鬱劑之盛行率分別為0.39%及0.44%。在SSRI、SNRI、TCA、其他類等四組使用頻率最高之藥品分別為fluoxetine、venlafaxine、imipramine和trazodone。大部分抗憂鬱劑使用族群為女性及13-18歲,SSRI使用於憂鬱症、焦慮症、強迫症、飲食疾患與雙極性情感疾患,TCA多使用於偏頭痛、夜尿或頻尿等疾病,SNRI則常用於憂鬱症、焦慮症及睡眠障礙。最常與抗憂鬱劑合併使用之精神藥物依序為anxiolytics、hypnotics & sedatives和stimulant。

結論
TCA與其他抗憂鬱劑(SSRI、SNRI和others)的使用情形有較大差異,包括年齡、性別等。SSRI、SNRI及其他類藥物以治療精神相關疾病為主,TCA有較高比例用於偏頭痛及尿液相關疾病。
英文摘要 Background
Antidepressants are proved to be effective on alleviating the depressive or anxious symptoms. Lack of clinical trials including children and adolescents due to ethical considerations would limit efficacy and safety data of antidepressants use, and restrict authorized indications. Promulgated warnings in pediatric population indicate that antidepressants use may elevate suicidal risk. According to those mentioned above, it is worth conducting retrospective database research to obtain some information in this population.
There were some studies on antidepressants conducted in Taiwan. Weakness such as lack of drug use information and limited subjects impeded an overview of antidepressants use in these populations in real world, and could not be extrapolated from adult population. The study aimed to focus on the prescribing pattern of antidepressants use on children and adolescents, and investigate the prevalence of antidepressants use in 2006 and 2007, the proportion of different categories of antidepressants, and clinical characteristics of target population.

Methods
First of all, we surveyed the antidepressants prevalence in 2006 and 2007 utilizing the 3:1 sampled National Health Insurance claims database (NHIRD) composed of children and adolescents younger than 18 years old. Next, we identified the first outpatient antidepressant prescription between 1 July 2006 and 31 December 2007, and we focus on analyzing the first prescription. We divided those population into four groups based on antidepressants use: SSRI, SNRI, TCA, and others. Clinical characteristics, such as demographic traits, mental disorder, co-morbidity, psychotropic co-medication, psychiatric visits, psychiatric hospitalization, physician specialty, hospital ranking, would be further investigated.

Results
The study showed that prevalence of antidepressants use in children and adolescents was 0.39% and 0.44% in 2006 and 2007, respectively. Leading drugs of SSRI, SNRI, TCA, and others were fluoxetine, venlafaxine, imipramine and trazodone, respectively. Those who were female or age between 13-18 years old were the major antidepressant users. SSRI were applied to treat depressive disorder, anxiety disorder, obsessive compulsive disorder, eating disorder, and bipolar disorder. TCA were mostly used for migraine, enuresis and urinary frequency. Lastly, SNRI were found to be prescribed for depressive disorder, anxiety disorder, and sleep disorder. The most concurrent psychotropic agents were anxiolytics, hypnotics & sedatives, and stimulants.

Conclusions
Utilization of TCA group presented a different trait compared with other groups, including age and gender. SSRI, SNRI, and others were mainly used for psychiatric diseases, while TCA was observed that migraine and urinary diseases were the major application.
論文目次 摘要 I
Abstract III
誌謝 V
目錄 VII
表目錄 X
圖目錄 XII
第一篇、台灣小兒門診抗憂鬱劑之處方型態分析 1
第一章、研究背景 1
第二章、文獻回顧 3
第一節、抗憂鬱劑之藥理機轉、特性與臨床作用 3
一、SSRI 3
二、SNRI 5
三、TCA 5
四、MAOI 6
五、Others 7
六、小結 7
第二節、抗憂鬱劑於小兒族群之臨床試驗、各國核准適應症與小兒精神疾患臨床治療指引 12
第三節、抗憂鬱劑處方型態相關研究 19
一、盛行率(prevalence)、性別與年齡分布 19
二、抗憂鬱劑種類與臨床診斷 20
第三章、研究目的與重要性 22
第四章、研究方法 23
第一節、研究設計 23
一、研究類型 23
二、研究材料與工具 23
三、研究對象與排除條件 25
四、基本資料 25
五、分組 26
六、研究流程 26
第二節、研究名詞、研究變項與操作定義 28
一、研究對象與研究藥品之定義 28
二、研究族群基本資料之定義 28
第三節、資料處理流程 34
第四節、統計資料分析 35
一、統計工具 35
二、統計模式設定 35
三、統計資料分析 35
第五章、研究結果 37
第一節、研究對象收入、排除與分組 37
第二節、兒童與青少年使用抗憂鬱劑之盛行率 37
第三節、各類抗憂鬱劑使用品項 37
第四節、病患基本特性 38
第五節、SSRI及TCA於憂鬱症治療之情形 46
第六章、研究討論 51
第一節、研究對象排除、收入與分組之分析 51
第二節、台灣小兒族群使用抗憂鬱劑盛行率分析 52
第三節、各類抗憂鬱劑使用品項之探討 55
一、SSRI 55
二、SNRI 56
第四節、病患基本特性之探討 57
一、抗憂鬱劑類別與性別年齡分布 57
二、Mental disorder & co-morbidity 58
三、精神門診就醫次數及精神疾患住院次數 62
第五節、SSRI及TCA於治療憂鬱症之探討 64
第六節、研究限制 66
第七章、結論與建議 67
第八章、未來研究方向 68
第二篇、過敏藥警訊系統建置與介面構想 69
第一章、服務背景 69
第二章、服務目的、工具與編纂流程 71
第一節、服務目的 71
第二節、服務工具與編纂流程 71
第三章、服務結果 73
第四章、服務結果探討與討論 78
第五章、如何改善過敏藥警訊系統? 85
第六章、實際應用 89
第七章、結論及未來方向 91
參考文獻 92
附錄:ATC code of categories 102

第一篇
Table 2.1-1 Pharmacological profile of SSRIs 4
Table 2.1-2 Overview of antidepressant use on psychiatric and non-psychiatric diagnoses & side effects 8
Table 2.2-1 Clinical studies of SSRI & SNRI 10
Table 2.2-2 FDA-, TFDA-, and UK-approved indication on antidepressants in pediatric population 10
Table 2.2-2 FDA-, TFDA-, and UK-approved indication on antidepressants in pediatric population (cont.) 11
Table 2.2-3 Clinical recommendation on psychiatric disorders in pediatric population 14
Table 2.3-1 Prevalence of antidepressants use in pediatric population 16
Table 2.3-2 Antidepressant subclasses and diagnoses in pediatric patients 17
Table 4.1-1各檔案間串檔變項說明 24
Table 4.2-1 Antidepressants and corresponding ATC codes 30
Table 4.2-2 Region of residence in Taiwan 31
Table 4.2-3共同使用精神相關藥品 31
Table 4.2-4 ICD-9-CM codes and corresponding diagnoses 33
Table 5.2-1 Prevalence of antidepressants use in Taiwan in 2006 and 2007 40
Table 5.4-1 Baseline characteristics of antidepressant users in pediatric population 42
Table 5.5-1 Baseline characteristics of SSRI &TCA users diagnosed with depressive disorder 48
Table 5.5-2 Average daily dosage in TCA users 50
Table 5.5-3 Dosage of TCA for depression treatment in pediatric population 50
Table 6.4-1 Comparison of antidepressants categories, gender & age distribution, and clinical diagnosis among different studies 59
第二篇
Table 2.2-1 Example of ciprofloxacin based on ATC system 72
Table 2.3-1初步排除範疇之範例列舉 74
Table 2.3-2正確性評估之項目範例列舉 74
Table 2.3-4純口服藥品<只列出前十名> 76
Table 2.3-5純針劑藥品<只列出前十名> 76
Table 2.3-6兼具針劑與口服劑型之藥品<只列出前十名> 77
Table 4.1-1藥品品項討論爭議與共識 81
Table 5.1-1 Common categories of drug allergy profiles 87
Table 6.1-1醫療品質暨病人安全委員會提案單 (節錄) 89
Table 6.1-2 Concise drug allergy categories 90
附錄:ATC code of categories 102

第一篇
Fig 4.1-1研究流程 27
Fig 5.1-1研究對象收入、排除與分組情況 39
Fig 5.3-1 Leading drugs of different pharmacological properties on antidepressants 41
Fig 6.2-1 Prevalence in different countries 54
第二篇
Fig 2.2-1 Algorithm of editing process 72
Fig 2.3-1 Algorithm of editing process & results 73
Fig 2.3-2正確性評估比例圖 77
Fig 5.1-1 Proposed design of drug allergy alerting system 86

參考文獻 1. Volkers, A.C., E.R. Heerdink, and L. van Dijk, Antidepressant use and off-label prescribing in children and adolescents in Dutch general practice (2001-2005). Pharmacoepidemiol Drug Saf, 2007. 16(9): p. 1054-62.
2. Tournier, M., et al., Patterns of antidepressant use in Quebec children and adolescents: trends and predictors. Psychiatry Res, 2010. 179(1): p. 57-63.
3. Zito, J.M., et al., Antidepressant prevalence for youths: a multi-national comparison. Pharmacoepidemiol Drug Saf, 2006. 15(11): p. 793-8.
4. Schneeweiss, S., et al., Comparative safety of antidepressant agents for children and adolescents regarding suicidal acts. Pediatrics, 2010. 125(5): p. 876-88.
5. Devi, S., Antidepressant-suicide link in children questioned. Lancet, 2012. 379(9818): p. 791.
6. Kuo, C.C., et al., Prevalence, correlates, and disease patterns of antidepressant use in Taiwan. Compr Psychiatry, 2011. 52(6): p. 662-9.
7. Wu, C.S., et al., Utilization of antidepressants in Taiwan: a nationwide population-based survey from 2000 to 2009. Pharmacoepidemiol Drug Saf, 2012.
8. DeBattista, C., Chapter 30. Antidepressant Agents, in Basic & Clinical Pharmacology, S.B.M. Bertram G. Katzung, Anthony J. Trevor Editor 2012.
9. Alan F. Schatzberg, C.B.N., The American Psychiatric Publishing Textbook of Psychopharmacology. 4th ed2009.
10. Alan F. Schatzberg, J.O.C., Charles DeBattista, Manual of clinical psychopharmacology. 6th ed2006.
11. Alan J. Gelenberg, M.P.F., John C. Markowitz, Jerrold F. Rosenbaum, Michael E. Thase, Madhukar H. Trivedi, Richard S. Van Rhoads. . Practice guideline for the treatment of patients with major depressive disorder. . Feb.16th 2012; Available from: http://www.psychiatryonline.com/pracGuide/pracGuideTopic_7.aspx. .
12. DeVane, C.L., Metabolism and pharmacokinetics of selective serotonin reuptake inhibitors. Cell Mol Neurobiol, 1999. 19(4): p. 443-66.
13. Leonard, H.L., et al., Pharmacology of the selective serotonin reuptake inhibitors in children and adolescents. J Am Acad Child Adolesc Psychiatry, 1997. 36(6): p. 725-36.
14. Carrasco, J.L. and C. Sandner, Clinical effects of pharmacological variations in selective serotonin reuptake inhibitors: an overview. Int J Clin Pract, 2005. 59(12): p. 1428-34.
15. Stahl, S.M., et al., SNRIs: their pharmacology, clinical efficacy, and tolerability in comparison with other classes of antidepressants. CNS Spectr, 2005. 10(9): p. 732-47.
16. Domenic A. Ciraulo, R.I.S., and David J. Greenblatt, Clinical pharmacology and therapeutics of antidepressants. 2nd ed2011. 436.
17. Gerretsen, P. and B.G. Pollock, Drugs with anticholinergic properties: a current perspective on use and safety. Expert Opin Drug Saf, 2011. 10(5): p. 751-65.
18. Taurines, R., et al., Pharmacotherapy in depressed children and adolescents. World J Biol Psychiatry, 2011. 12 Suppl 1: p. 11-5.
19. Stahl, S.M. and A. Felker, Monoamine oxidase inhibitors: a modern guide to an unrequited class of antidepressants. CNS Spectr, 2008. 13(10): p. 855-70.
20. Croom, K.F., C.M. Perry, and G.L. Plosker, Mirtazapine: a review of its use in major depression and other psychiatric disorders. CNS Drugs, 2009. 23(5): p. 427-52.
21. Benjamin, S. and P.M. Doraiswamy, Review of the use of mirtazapine in the treatment of depression. Expert Opin Pharmacother, 2011. 12(10): p. 1623-32.
22. Stahl, S.M., Mechanism of action of trazodone: a multifunctional drug. CNS Spectr, 2009. 14(10): p. 536-46.
23. Rosenberg, D.R., Chapter 8. Tricyclic Antidepressants, in Pharmacotherapy for Child and Adolescent Psychiatric Disorders, P.A.D. Samuel Gershon , and David R. Rosenberg Editor 2002, Informa Healthcare.
24. Rosenberg, D.R., Chapter 9. Selective Serotonin-Reuptake Inhibitors, in Pharmacotherapy for Child and Adolescent Psychiatric Disorders, P.A.D. Samuel Gershon , and David R. Rosenberg, Editor 2002, Informa Healthcare.
25. Davanzo, P.A., Chapter 10. Novel (atypical) antidepressants, in Pharmacotherapy for Child and Adolescent Psychiatric Disorders, P.A.D. Samuel Gershon , and David R. Rosenberg Editor 2002, Informa Healthcare
26. Davanzo, P.A., Chapter 11. Monoamine Oxidase Inhibitors, in Pharmacotherapy for Child and Adolescent Psychiatric Disorders, P.A.D. Samuel Gershon , and David R. Rosenberg Editor 2002, Informa Healthcare.
27. Tsapakis, E.M., et al., Efficacy of antidepressants in juvenile depression: meta-analysis. Br J Psychiatry, 2008. 193(1): p. 10-7.
28. Uthman, O.A. and J. Abdulmalik, Comparative efficacy and acceptability of pharmacotherapeutic agents for anxiety disorders in children and adolescents: a mixed treatment comparison meta-analysis. Curr Med Res Opin, 2010. 26(1): p. 53-9.
29. Geller, D.A., et al., Fluoxetine treatment for obsessive-compulsive disorder in children and adolescents: a placebo-controlled clinical trial. J Am Acad Child Adolesc Psychiatry, 2001. 40(7): p. 773-9.
30. Wagner, K.D., et al., Efficacy of sertraline in the treatment of children and adolescents with major depressive disorder: two randomized controlled trials. JAMA, 2003. 290(8): p. 1033-41.
31. Sheehan, D.V. and K. Kamijima, An evidence-based review of the clinical use of sertraline in mood and anxiety disorders. Int Clin Psychopharmacol, 2009. 24(2): p. 43-60.
32. Rynn, M.A., L. Siqueland, and K. Rickels, Placebo-controlled trial of sertraline in the treatment of children with generalized anxiety disorder. Am J Psychiatry, 2001. 158(12): p. 2008-14.
33. Emslie, G.J., et al., Paroxetine treatment in children and adolescents with major depressive disorder: a randomized, multicenter, double-blind, placebo-controlled trial. J Am Acad Child Adolesc Psychiatry, 2006. 45(6): p. 709-19.
34. Geller, D.A., et al., Paroxetine treatment in children and adolescents with obsessive-compulsive disorder: a randomized, multicenter, double-blind, placebo-controlled trial. J Am Acad Child Adolesc Psychiatry, 2004. 43(11): p. 1387-96.
35. Wagner, K.D., et al., A multicenter, randomized, double-blind, placebo-controlled trial of paroxetine in children and adolescents with social anxiety disorder. Arch Gen Psychiatry, 2004. 61(11): p. 1153-62.
36. Carandang, C., et al., A review of escitalopram and citalopram in child and adolescent depression. J Can Acad Child Adolesc Psychiatry, 2011. 20(4): p. 315-24.
37. Emslie, G.J., et al., Venlafaxine ER for the treatment of pediatric subjects with depression: results of two placebo-controlled trials. J Am Acad Child Adolesc Psychiatry, 2007. 46(4): p. 479-88.
38. March, J.S., et al., A Randomized controlled trial of venlafaxine ER versus placebo in pediatric social anxiety disorder. Biol Psychiatry, 2007. 62(10): p. 1149-54.
39. Olvera, R.L., et al., An open trial of venlafaxine in the treatment of attention-deficit/hyperactivity disorder in children and adolescents. J Child Adolesc Psychopharmacol, 1996. 6(4): p. 241-50.
40. Prakash, A., et al., An open-label safety and pharmacokinetics study of duloxetine in pediatric patients with major depression. J Child Adolesc Psychopharmacol, 2012. 22(1): p. 48-55.
41. Mahmoudi-Gharaei, J., et al., Duloxetine in the treatment of adolescents with attention deficit/hyperactivity disorder: an open-label study. Hum Psychopharmacol, 2011. 26(2): p. 155-60.
42. Meighen, K.G., Duloxetine treatment of pediatric chronic pain and co-morbid major depressive disorder. J Child Adolesc Psychopharmacol, 2007. 17(1): p. 121-7.
43. U S Food and Drug Administration. 02/29/2012 [cited 2012 March 1st]; Available from: http://www.fda.gov/.
44. 行政院衛生署. [cited 2012 March 1st]; Available from: http://www.doh.gov.tw.
45. eMC (eletronic Medicines Compendium). [cited 2012 23rd, May]; Available from: http://www.medicines.org.uk.
46. Desarkar, P., A. Das, and V.K. Sinha, Duloxetine for childhood depression with pain and dissociative symptoms. Eur Child Adolesc Psychiatry, 2006. 15(8): p. 496-9.
47. Ryan, N.D., Treatment of depression in children and adolescents. Lancet, 2005. 366(9489): p. 933-40.
48. Lim, C.J., et al., Antidepressant-induced manic conversion: a developmentally informed synthesis of the literature. Int Rev Neurobiol, 2005. 65: p. 25-52.
49. Chang, K., Challenges in the diagnosis and treatment of pediatric bipolar depression. Dialogues Clin Neurosci, 2009. 11(1): p. 73-80.
50. in Depression in Children and Young People: Identification and Management in Primary, Community and Secondary Care2005: Leicester (UK).
51. Hughes, C.W., et al., Texas Children's Medication Algorithm Project: update from Texas Consensus Conference Panel on Medication Treatment of Childhood Major Depressive Disorder. J Am Acad Child Adolesc Psychiatry, 2007. 46(6): p. 667-86.
52. Connolly, S.D. and G.A. Bernstein, Practice parameter for the assessment and treatment of children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry, 2007. 46(2): p. 267-83.
53. Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry, 2012. 51(1): p. 98-113.
54. Fritz, G., et al., Practice parameter for the assessment and treatment of children and adolescents with enuresis. J Am Acad Child Adolesc Psychiatry, 2004. 43(12): p. 1540-50.
55. Yang, S.S., et al., Treatment guideline of enuresis in Taiwan. Acta Paediatr Taiwan, 2001. 42(5): p. 271-7.
56. Zito, J.M., et al., Rising prevalence of antidepressants among US youths. Pediatrics, 2002. 109(5): p. 721-7.
57. Vitiello, B., S.H. Zuvekas, and G.S. Norquist, National estimates of antidepressant medication use among U.S. children, 1997-2002. J Am Acad Child Adolesc Psychiatry, 2006. 45(3): p. 271-9.
58. Percudani, M., et al., Antidepressant drug use in Lombardy, Italy: a population-based study. J Affect Disord, 2004. 83(2-3): p. 169-75.
59. 行政院衛生署中央健康保險局業務執行報告-95年度. [cited 2012 15th, May]; Available from: http://www.nhi.gov.tw/Resource/webdata/Attach_8957_2_140業務執行報告.pdf.
60. 行政院衛生署中央健康保險局業務執行報告-97年度. [cited 2012 15th, May]; Available from: http://www.nhi.gov.tw/Resource/webdata/Attach_10945_2_153執行報告.pdf.
61. 行政院內政部統計年報-人口年齡分配. [cited 2012 14th, May]; Available from: http://sowf.moi.gov.tw/stat/year/y02-01.xls.
62. 國家衛生研究院全民健康保險資料庫:各檔案間串檔變項說明. [cited 2012 Mar. 27th]; Available from: http://w3.nhri.org.tw/nhird/file_date/en_codedescribe.pdf.
63. Kao, Y.-H., et al., Classification of Pharmaceutical Products Reimbursed by National Health Insurance by the ATC System The Chinese Pharmaceutical Journal, 2002. 54: p. 283-290.
64. 行政院衛生署中央健康保險局 2001 ICD-9-CM 疾病碼一覽表. 2012 [cited 2012 Mar. 27th]; Available from: http://www.nhi.gov.tw/Resource/webdata/Attach_3469_2_ICD2001-更新版.pdf.
65. 行政院衛生署中央健保局-健保醫療服務-健保用藥. [cited 2012 26th, May]; Available from: http://www.nhi.gov.tw/query/query1.aspx?menu=18&menu_id=683&webdata_id=3468&WD_ID=756.
66. Drug Information Handbook. 20th ed: American Pharmacists Association (APhA).
67. Micromedex 2.0. [cited 2012 Feb 17th]; Available from: http://www.thomsonhc.com/micromedex2/librarian/
68. FDA talk Paper. [cited 2012 15th, May]; Available from: http://www.fda.gov/cder/drug/advisory/mdd.htm.
69. Patel, V., Mental health in low- and middle-income countries. Br Med Bull, 2007. 81-82: p. 81-96.
70. Thapar, A., et al., Depression in adolescence. Lancet, 2012. 379(9820): p. 1056-67.
71. National Conference of State Legislatures-Children's Health Insurance Program Overview. [cited 2012 15th, May]; Available from: http://www.ncsl.org/issues-research/health/childrens-health-insurance-program-overview.aspx.
72. Sevilla-Dedieu, C., et al., Seeking help for mental health problems outside the conventional health care system: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD). Can J Psychiatry, 2010. 55(9): p. 586-97.
73. Vaswani, M., F.K. Linda, and S. Ramesh, Role of selective serotonin reuptake inhibitors in psychiatric disorders: a comprehensive review. Prog Neuropsychopharmacol Biol Psychiatry, 2003. 27(1): p. 85-102.
74. U S Food and Drug Administration. 02/29/2012 [cited 2012 16th, May]; Available from: http://www.fda.gov/.
75. Eaton, L., European agency approves use of fluoxetine for children and teens. BMJ, 2006. 332: p. 1407.
76. 行政院衛生署. [cited 2012 16th, May]; Available from: http://www.doh.gov.tw.
77. Kurian, B.T., et al., Effect of regulatory warnings on antidepressant prescribing for children and adolescents. Arch Pediatr Adolesc Med, 2007. 161(7): p. 690-6.
78. Marks, D.M., et al., Paroxetine: safety and tolerability issues. Expert Opin Drug Saf, 2008. 7(6): p. 783-94.
79. U.S FDA-Drug. [cited 2012 16th, May]; Available from: http://www.fda.gov/cder/drug/infopage/paxil/default.htm.
80. Pamer, C.A., et al., Changes in US antidepressant and antipsychotic prescription patterns during a period of FDA actions. Pharmacoepidemiol Drug Saf, 2010. 19(2): p. 158-74.
81. Olfson, M., S.C. Marcus, and B.G. Druss, Effects of Food and Drug Administration warnings on antidepressant use in a national sample. Arch Gen Psychiatry, 2008. 65(1): p. 94-101.
82. Murray, M.L., C.S. de Vries, and I.C. Wong, A drug utilisation study of antidepressants in children and adolescents using the General Practice Research Database. Arch Dis Child, 2004. 89(12): p. 1098-102.
83. Brown, M.L., A.W. Pope, and E.J. Brown, Treatment of primary nocturnal enuresis in children: a review. Child Care Health Dev, 2011. 37(2): p. 153-60.
84. Chang, P., et al., An epidemiological study of nocturnal enuresis in Taiwanese children. BJU Int, 2001. 87(7): p. 678-81.
85. Cher, T.W., G.J. Lin, and K.H. Hsu, Prevalence of nocturnal enuresis and associated familial factors in primary school children in taiwan. J Urol, 2002. 168(3): p. 1142-6.
86. Tai, H.L., et al., The epidemiology and factors associated with nocturnal enuresis and its severity in primary school children in Taiwan. Acta Paediatr, 2007. 96(2): p. 242-5.
87. Hetrick, S., et al., Selective serotonin reuptake inhibitors (SSRIs) for depressive disorders in children and adolescents. Cochrane Database Syst Rev, 2007(3): p. CD004851.
88. Ipser, J.C., et al., Pharmacotherapy for anxiety disorders in children and adolescents. Cochrane Database Syst Rev, 2009(3): p. CD005170.
89. Couturier, J. and J. Lock, A review of medication use for children and adolescents with eating disorders. J Can Acad Child Adolesc Psychiatry, 2007. 16(4): p. 173-6.
90. Treasure, J., A.M. Claudino, and N. Zucker, Eating disorders. Lancet, 2010. 375(9714): p. 583-93.
91. Zink, M., S. Englisch, and A. Meyer-Lindenberg, Polypharmacy in schizophrenia. Curr Opin Psychiatry, 2010. 23(2): p. 103-11.
92. Barak, Y., M. Swartz, and Y. Baruch, Venlafaxine or a second SSRI: Switching after treatment failure with an SSRI among depressed inpatients: a retrospective analysis. Prog Neuropsychopharmacol Biol Psychiatry, 2011. 35(7): p. 1744-7.
93. Ricca V, M.E., Paionni A, Di Bernardo M, Cellini M, Cabras PL, Rotella CM., Venlafaxine versus fluoxetine in the treatment of atypical anorectic outpatients: a preliminary study. Eat Weight Disord, 1999. 4(1): p. 10-4.
94. Chen, Y.C., et al., Comorbidity profiles of chronic migraine sufferers in a national database in Taiwan. J Headache Pain, 2012.
95. Lewis, D., et al., Practice parameter: pharmacological treatment of migraine headache in children and adolescents: report of the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society. Neurology, 2004. 63(12): p. 2215-24.
96. Malini Haria, A.F., Donna McTavish, Trazodone: A review of its pharmacology, therapeutic use in depression and therapeutic potential in other disorders. Drugs & Aging, 1994. 4(4): p. 331-55.
97. 行政院衛生署中央健康保險局-藥材專區-藥品給付規定. [cited 2012 18th, May]; Available from: http://www.nhi.gov.tw/Resource/webdata/20928_1_藥品給付規定條文.doc.
98. Ma, J., K.V. Lee, and R.S. Stafford, Depression treatment during outpatient visits by U.S. children and adolescents. J Adolesc Health, 2005. 37(6): p. 434-42.
99. Rao, U. and L.A. Chen, Characteristics, correlates, and outcomes of childhood and adolescent depressive disorders. Dialogues Clin Neurosci, 2009. 11(1): p. 45-62.
100. Anderson, I.M., Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability. J Affect Disord, 2000. 58(1): p. 19-36.
101. Donoghue, J., Antidepressant use patterns in clinical practices: comparisons among tricyclic antidepressants and selective serotonin reuptake inhibitors. Acta Psychiatr Scand Suppl, 2000. 403: p. 57-61.
102. Rosholm, J.U., M. Andersen, and L.F. Gram, Are there differences in the use of selective serotonin reuptake inhibitors and tricyclic antidepressants? A prescription database study. Eur J Clin Pharmacol, 2001. 56(12): p. 923-9.
103. Maric, N.P., et al., Factors influencing the choice of antidepressants: a study of antidepressant prescribing practice at University Psychiatric Clinic in Belgrade. Vojnosanit Pregl, 2012. 69(4): p. 308-13.
104. Hoffmann, F., et al., Outpatient treatment in German adolescents with depression: an analysis of nationwide health insurance data. Pharmacoepidemiol Drug Saf, 2012.
105. 聯合新聞網-健康醫藥-醫藥新聞. 忘了他過敏 2醫師開錯藥起訴 [cited 2012 Jun 15th]; Available from: http://udn.com/NEWS/HEALTH/HEA1/7160951.shtml#ixzz1xsV54iY6.
106. 財團法人醫院評鑑暨醫療品質策進會-資料下載-101年醫院評鑑與教學醫院評鑑說明會. [cited 2012 26th, May]; Available from: http://www.tjcha.org.tw/Upload/523DBEE4-F56F-4B20-941C-5D1D308BF069/8.醫院評鑑說明會簡報%20(第2.4-2.6章).pdf.
107. Hsieh, T.C., et al., Characteristics and consequences of drug allergy alert overrides in a computerized physician order entry system. J Am Med Inform Assoc, 2004. 11(6): p. 482-91.
108. Hunteman, L., et al., Analysis of allergy alerts within a computerized prescriber-order-entry system. Am J Health Syst Pharm, 2009. 66(4): p. 373-7.
109. 許筱晴等人, 提升藥物過敏之標註性與正確性, in 台灣臨床藥學會2011.
110. MIMS.com-台灣. [cited 2012 20th,May]; Available from: http://www.mims.com/Taiwan.
111. WHOCC-ATC/DDD Index. [cited 2012 20th, May]; Available from: http://www.whocc.no/atc_ddd_index/.
112. Natsch, S., et al., Application of the ATC/DDD methodology to monitor antibiotic drug use. Eur J Clin Microbiol Infect Dis, 1998. 17(1): p. 20-4.
113. 行政院衛生署-藥物、醫療器材、化妝品許可證查詢作業. [cited 2012 20th, May]; Available from: http://www.fda.gov.tw/licnquery/DO8180.asp.
論文全文使用權限
  • 同意授權校內瀏覽/列印電子全文服務,於2017-07-26起公開。
  • 同意授權校外瀏覽/列印電子全文服務,於2017-07-26起公開。


  • 如您有疑問,請聯絡圖書館
    聯絡電話:(06)2757575#65773
    聯絡E-mail:etds@email.ncku.edu.tw