在精神分裂症患者中将抗精神病药物转换为部分多巴胺D2-激动剂:叙述性综述
Pierre Baumann1, Philipp Bauknecht2, Maxim Kuzin3
1Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
International journal of psychiatry in clinical practice
|July 10, 2023
概括
在精神分裂症中将抗精神病药物切换为部分D2-多巴胺激动剂 (PD2A),如阿里皮普拉,布雷克斯皮普拉或卡里普拉,由于研究方法的多样性,缺乏首选的策略. 为了更好地比较临床结果,需要标准化的协议.
科学领域:
- 精神病学和药理学 精神病学和药理学
- 神经科学是一个神经科学.
- 临床研究 临床研究
背景情况:
- 精神分裂症的治疗通常涉及抗精神病药物.
- 转换为部分D2-多巴胺激动剂 (PD2A),如阿里皮普拉 (ARI),布雷克斯皮普拉 (BREX) 或卡里普拉 (CARI) 是另一种策略.
- 关于这些开关的临床结果的比较数据有限.
研究的目的:
- 分析关于在精神分裂症患者中将抗精神病药物切换为PD2A的临床结果的文献.
- 为了比较不同的切换策略及其有效性.
主要方法:
- 对2002年以后的研究进行了PubMed文献搜索 (2021年2月,更新至2022年1月).
- 定义了六种切换策略:突然,逐步,交叉渐变和混合方法.
- 主要结局是每个策略的全因停药率.
主要成果:
- 大多数研究集中在转向ARI (10份报告),较少的研究集中在BREX (4份报告).
- 只有一个研究涉及CARI,这不是一个交换研究.
- 方法上的差异 (持续时间,剂量,先前的药物治疗) 阻碍了研究的直接比较.
结论:
- 目前的证据不支持在精神分裂症中对PD2A进行首选的切换策略.
- 研究方案的显著差异阻止了明确的结论.
- 建议采用标准化的临床方案,以便可靠地比较切换策略和临床结果.
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