Text/Yangcheng Evening News all-media reporter Zhang Hua
On January 1, the new version of the national medical insurance drug list was implemented, and patients with severe mental disorders also benefited from it. According to the reporter's understanding, at present, psychiatry experts recommend that patients with schizophrenia (referred to as "sperm") use the first self-developed second-generation antipsychotic drug long-acting injection risperidone microspheres (II) for injection smoothly entered the medical insurance directory, bringing new hope for the reintegration of about 10 million schizophrenic patients in China, and also greatly reducing its treatment costs.
Schizophrenia is a "malignant tumor" of the psychiatric system
China's self-developed second-generation antipsychotic long-acting injections have entered the medical insurance directory, which makes psychiatric experts feel happy.
Liu Tiebang, director of the Shenzhen Mental Health Center and president of Shenzhen Corning Hospital, introduced to reporters that schizophrenia is the most important mental illness faced by the Department of Psychiatry, and now 30%-35% of the inpatients of Corning Hospital are schizophrenic patients, while more than half of the schizophrenia patients in Shenzhen community management objects. According to statistics, Corning Hospital has about 2,000 outpatient visits per day, of which 14,000-1,500 people are schizophrenia. Therefore, it can be said that fine points are a major disease and common disease of psychiatry.
Liu Tiebang said that schizophrenia, like a "malignant tumor" of the psychiatric system, is one of the most severe challenges facing psychiatry. The treatment of this disease is difficult, the prognosis of patients is poor, and the treatment effect is not satisfactory. "From the perspective of symptoms, the spiritual world of sperm patients is detached from reality, most patients are sensitive and suspicious, there are symptoms such as auditory hallucinations, persecution delusions, and even some patients attack innocent people under the domination of delusion; from the prognosis point of view, about 1/3 of the current global sperm patients can be cured, 1/3 of the patients have improved, and the remaining 1/3 of the patients are ineffective or even worse and worse."
The proportion of people with schizophrenia who are eventually able to return to society is not high. The disease often accompanies the patient for life, which is largely due to its "high recurrence" characteristics. Liu Tiebang described the high recurrence of fine scores this way: "These patients often have repeated attacks and repeated hospitalizations, which is called the 'revolving door effect' in the industry, that is, schizophrenic patients just go out from the left door and enter the hospital from the right door." Many patients go in and out of the hospital for the rest of their lives. ”
According to Liu Tiebang, many schizophrenic patients have been hospitalized for a long time, lost the opportunity to work and go to school, and cannot obtain income, and many families have become poor due to illness. "Sperm patients not only endure the pain and suffering of their own diseases, but also bring deep suffering to their families, and their entire families often need to spend a lot of time, energy and money to care for and treat sperm patients."
There are no curative drugs, and long-acting injections are an important treatment strategy
Liu Tiebang told reporters that the current cause of schizophrenia is unknown, there is no cure drug, plus this is a recurrent chronic prolonged disease, and the repeated illness caused by the interruption of treatment or self-medication is the main difficulty in the treatment of schizophrenia at present. The data show that 60% of patients with first-time seizures have poor medication compliance, and the recurrence rate within 5 years exceeds 80%. Multiple relapses lead to prolongation of the course of the disease, increase the difficulty of treatment, and also greatly increase the cost of treatment.
Because of this, more and more experts advocate the use of long-acting injections in the clinic. In early November 2021, Nasrallah, a professor in the Department of Psychiatry at St. Louis University School of Medicine, published an article titled "I Have a Dream Psychiatric Edition", in which he mentioned that "I hope that antipsychotics and antidepressant long-acting preparations can be more applied", which has a great impact on the industry.
Liu Tiebang also agreed with Professor Nasrallah's point of view, saying, "Antipsychotic long-acting injections can significantly improve patient compliance compared with oral preparations, and are an important treatment strategy for preventing recurrence." For patients with aggression and violence, long-acting injections can reduce the burden of care and maintain social stability. ”
Unfortunately, the proportion of sperm patients who use long-acting injections in China is only 2%-3%. Liu Tiebang analysis said that the lower use rate is often related to the domestic treatment concept and the cost burden of patients, but the use of long-acting injections is an important trend in the field of psychiatry.
"We believe that the biggest obstacle to the current treatment of fine scores is that patients do not use drugs well and have low compliance. In fact, the current drug treatment effect is good, as long as the drug is standardized, 70%-80% of patients can control hallucinatory delusions, attacks, violent behavior and other symptoms, long-acting injections can improve medication compliance. Liu Tiebang said.
Long-acting injections bring new hope to patients back into society
Liu Tiebang took Resinto as an example, "Risperidone itself has a good effect on schizophrenia, and Resperidol as a long-acting injection of risperidone, injected every two weeks, can not only significantly improve the oral drug in patients with schizophrenia medication compliance is too low, but also to achieve a stable blood drug concentration, compared with oral preparations to narrow the difference between the peak and trough of blood concentration, is conducive to reducing the risk of dose-dependent side effects, improve the safety of medication for patients." ”
"Long-acting injection shortens the initial delay period of drug release by improving the drug release mode, and its rapid onset of action after injection can quickly control the patient's psychotic symptoms and quickly clear after stopping the drug, which is more conducive to the doctor's rapid adjustment of the treatment plan according to the condition." Liu Tiebang further said, "It is very happy to see that China has achieved preparation innovation in the field of schizophrenia treatment, providing patients with new drugs with more clinical advantages. It is believed that with the use of long-acting injections, it can bring new hopes for more patients to improve their prognosis and return to society. ”
As an expert in the long-term treatment of serious mental disorders, Liu Tiebang is full of care and understanding for patients with sperm, and his appeal is that "I hope that society will be more tolerant of mentally ill people and give more care to the families of mentally ill people." The first independent innovation of microsphere preparation Ruixinto in China can be included in medical insurance, which is a big gospel for the majority of schizophrenic patients, with the reduction of the burden of treatment costs, I believe that more patients will benefit from the drug, improve compliance, and then reduce recurrence. ”
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Source | Yangcheng Evening News Yangcheng Pie
Image | Visual China
Editor-in-charge | Lv Hang