抗精神病药对精神分裂症患者睡眠的不良影响. 系统审查和元分析
Yarmila Elena Valencia Carlo1, Ricardo Arturo Saracco-Alvarez2, Verónica Angela Valencia Carlo3
1Health Sciences Program, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico.
Frontiers in psychiatry
|July 13, 2023
概括
这次审查发现,抗精神病药物通常会导致精神分裂症患者的失眠和嗜睡等睡眠障碍. 一些药物,如promazine和amisulpride,似乎更安全的睡眠比其他药物,如齐普拉西和haloperidol.
科学领域:
- 精神病学和药理学 精神病学和药理学
- 睡眠医学 睡眠医学
- 基于证据的医学基于证据的医学.
背景情况:
- 在精神分裂症患者中,睡眠障碍很普遍.
- 抗精神病药物是精神分裂症治疗的基石,但可能导致不良影响.
- 了解不同抗精神病药物对睡眠的影响对于优化患者护理至关重要.
研究的目的:
- 系统地审查和对接受抗精神病治疗的精神分裂症患者对睡眠的不良影响进行元分析.
- 确定哪些抗精神病药物与失眠,嗜睡和镇静的风险增加有关.
- 为了比较各种抗精神病药物关于睡眠相关不良事件的安全性概况.
主要方法:
- 在多个数据库 (PubMed,Embase,Cochrane等) 中进行了系统的搜索. 对于在1990年1月至2021年10月期间发表的合格随机临床试验.
- 使用CONSORT列表和Cochrane偏差工具评估了方法质量.
- 使用贝叶斯随机效应模型进行了网络元分析,并使用元回归来分析关联.
主要成果:
- 确定了87项试验,其中70项被纳入了元分析;47项研究具有低或中等偏差风险.
- 常见的不良反应包括失眠,嗜睡和镇静.
- 齐普拉西增加了失眠的风险 (OR,1.56). 哈洛佩里多尔,卢拉西和齐普拉西增加了昏昏欲睡的风险 (ORs 1.90-2.25). 珀菲纳,哈洛佩里多尔和RISPERIDONE增加了镇静的风险 (ORs2.41-5.33).
结论:
- 失眠,镇静和昏昏欲睡是与精神分裂症抗精神病药物使用相关的常见不良睡眠影响.
- хлорпромазин, clozapine, flupentixol, 西龙, 和 amisulpride 显示出对睡眠的有利安全性.
- 齐普拉西,珀费纳,哈洛皮多尔和瑞斯佩里与睡眠相关的不良反应的风险更高有关.
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