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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.
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Submitted on : Monday, December 16, 2013 - 12:47:08 PM
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  • HAL Id : tel-00919103, version 1


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⟩



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