2代目の抗精神病薬の心臓代謝リスクは,子供や青少年における初回使用時の第2世代の抗精神病薬である
Christoph U Correll1, Peter Manu, Vladimir Olshanskiy
1Zucker Hillside Hospital, Psychiatry Research, North Shore-Long Island Jewish Health System, 75-59 263rd St, Glen Oaks, NY 11004, USA. ccorrell@lij.edu
JAMA
|October 29, 2009
まとめ
第2世代の抗精神病薬は,若年において著しい体重増加を引き起こします. メタボリックの変化は薬によって異なるが,オランザピンとケティアピンは脂質とトリグリセリドの増加について最も懸念を示している.
科学分野:
- 小児精神科は,小児精神科を専門とする.
- 薬理学 薬理学とは
- メタボリック研究
背景:
- 第2世代の抗精神病薬 (SGA) の心臓代謝リスクは懸念されています.
- 抗精神病薬に慣れていない小児および青少年集団におけるこれらの効果に関する研究は限られている.
研究 の 目的:
- SGAと体構成および代謝パラメータとの関連を調査する.
- 前もって抗精神病薬に曝露していない患者に焦点を当てる.
主な方法:
- 4歳から19歳までの若者の非ランダム化コホート研究 (SATIETY).
- アリピプラゾール,オランザピン,ケチアピン,リスペリドーンを12週間投与する.
- 治療を受けていないグループと比較した結果.
主要な成果:
- 4つのSGAすべては,コントロールと比較して,著しい体重増加をもたらしました.
- オランザピンとクエティアピンは,総コレステロール,トリグリセリド,非HDLコレステロールの有意な増加を示した.
- リスペリドンはトリグリセリドを増加させ,アリピプラゾールは有意な代謝変化を示さなかった.
結論:
- 若年におけるSGAの開始は,かなりの体重増加と関連しています.
- メタボリックの変化は,研究されたSGAs間で異なっており,個別化されたモニタリングの必要性を強調しています.
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