Etudes pharmaco-épidémiologiques des neuroleptiques chez les sujets âgés et les patients souffrant de schizophrénie

Abstract : Context : Antipsychotic drugs (AD) are often prescribed to elderly people and patients with schizophrenia and both populations are fragile. The aim of the present thesis was to investigate the impact of AD in these patients, in a real-life setting. Study 1. Antipsychotic drug use during a heatwave and risk of death, in older people. Using data from the French Social Security, prescriptions of older people who died during the heatwave in August 2003 (n=11624) were compared to these of controls who survived. An association was evidenced between a prescription of AD and death, in the periods just preceding and during the heatwave, independently of other psychotropic drugs, dementia or cardiac disease. Study 2. Effectiveness of AD in schizophrenia patients. Using data from a French nationwide observational study, we found that in patients treated for schizophrenia (n=5500), a higher level of satisfaction was independently associated with being on second-generation AD as compared to first-generation AD. Also, in drug-naive patients (n=467) followed up during 6 months after a first AD initiation, one third of the patients did not experience any improvement of symptoms. The factors predictive of a better clinical response were lower levels of baseline negative symptoms and overall severity of symptoms. A total of 5 trajectories of clinical evolution were identified.
Document type :
Theses
Complete list of metadatas

Cited literature [142 references]  Display  Hide  Download

https://tel.archives-ouvertes.fr/tel-00919103
Contributor : Abes Star <>
Submitted on : Monday, December 16, 2013 - 12:47:08 PM
Last modification on : Tuesday, April 16, 2019 - 3:58:44 AM
Long-term archiving on : Tuesday, March 18, 2014 - 4:25:13 PM

File

va_nordon_clementine.pdf
Version validated by the jury (STAR)

Identifiers

  • HAL Id : tel-00919103, version 1

Collections

Citation

Clémentine Nordon. Etudes pharmaco-épidémiologiques des neuroleptiques chez les sujets âgés et les patients souffrant de schizophrénie. Médecine humaine et pathologie. Université René Descartes - Paris V, 2013. Français. ⟨NNT : 2013PA05S017⟩. ⟨tel-00919103⟩

Share

Metrics

Record views

344

Files downloads

2780