在儿童和青少年首次使用第二代抗精神病药物的心脏代谢风险
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
概括
第二代抗精神病药物在年轻人中引起显著的体重增加. 代谢变化因药物而异,奥兰扎平和奎平显示最关心的脂质和甘油三激素增加.
科学领域:
- 儿科精神病学 儿科精神病学
- 药理学 药理学是指药理学的学科.
- 代谢研究研究 代谢研究
背景情况:
- 第二代抗精神病药物 (SGA) 的心脏代谢风险令人担忧.
- 有限的研究存在于这些对抗精神病药物原始的儿科和青少年群体的影响.
研究的目的:
- 调查SGA与人体组成和代谢参数之间的关联.
- 专注于没有先前接触过抗精神病药物的患者.
主要方法:
- 在4-19岁的年轻人中进行非随机队列研究 (SATIETY).
- 使用阿里皮普拉,奥兰沙平,奎蒂亚平或瑞斯佩里治疗12周.
- 将结果与未接受治疗的组进行比较.
主要成果:
- 与对照组相比,所有四个SGA都导致了显著的体重增加.
- 奥兰沙平和奎蒂阿平显著增加了总胆固醇,甘油三和非高密度胆固醇.
- 里斯佩里顿增加了甘油三水平;阿里皮普拉没有显著的代谢变化.
结论:
- 在年轻人中启动SGA与显著的体重增加有关.
- 在研究的SGA中,代谢变化有所不同,这突显了需要个性化监测的必要性.
相关概念视频
Antipsychotic Drugs: Typical and Atypical Agents
Antipsychotic drugs are classified into first-generation (typical) drugs including phenothiazines; and second-generation (atypical) drugs. Chlorpromazine hydrochloride (Thorazine), a phenothiazine derivative, broadly impacts the central, autonomic, and endocrine systems. This drug, along with typical agents like haloperidol (Haldol), primarily works by antagonizing D2 receptors, thus reducing dopaminergic neurotransmission. However, typical antipsychotics can cause side effects such as sedation...
Psychosis and Antipsychotic Drugs: Overview
The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic symptoms in all...
Antidepressant Drugs: MAOIs and Other Agents
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
Antipsychotic Drugs: Therapeutic Uses and Side Effects
Antipsychotic drugs primarily block dopamine and serotonin receptors and cholinergic, adrenergic, and histaminergic receptors, thereby reducing hallucinations and delusions in conditions like schizophrenia. However, they can trigger unwanted extrapyramidal effects such as dystonias, Parkinson-like symptoms, and tardive dyskinesia.
Despite these side effects, antipsychotics are used therapeutically for various purposes, including managing schizophrenia, preventing nausea and vomiting, curbing...
Despite these side effects, antipsychotics are used therapeutically for various purposes, including managing schizophrenia, preventing nausea and vomiting, curbing...
Psychosis: Goals of Pharmacotherapy
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation. For...
Mania and Antimanic Drugs: Overview
Mania, a psychological condition characterized by elevated mood, increased energy, and reduced sleep need, is part of the bipolar disorder cycle. The exact cause of mania isn't entirely known, but it is thought to be a combination of genetic, environmental, and neurological factors. Bipolar disorder involves alternating manic and depressive episodes. Mood stabilizers like lithium, antipsychotics, and anticonvulsants help manage these episodes. Lithium carbonate is particularly effective as a...
