长效注射抗精神病药物的比较安全性:系统性审查和网络元分析
Erasmo Saucedo Uribe1,2,3, Samuel Enrique Olivares Mundo1,2, Raul Ricardo Medrano Garza1,2
1Department of Psychiatry, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, México.
Psychiatry investigation
|January 1, 2024
概括
长效注射抗精神病药 (LAI) 在治疗精神分裂症的一般副作用方面显示出与安慰剂相比的安全性. 然而,大多数LAI可以减少严重的不良事件和因任何原因中止治疗,而阿里皮普拉在防止因不良事件而中止治疗方面表现出色.
科学领域:
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 精神分裂症 (SCZ) 和精神分裂情绪障碍 (SZA) 是严重的心理健康状况,通常用抗精神病药物治疗.
- 长效注射抗精神病药 (LAI) 提供一种替代的施用途径,有可能改善坚持和结果.
- 在临床决策过程中,不同 LAI 和安慰剂之间的安全性数据的比较至关重要.
研究的目的:
- 系统地评估和比较各种LAI的安全性概况,并将其与其他药物和安慰剂进行比较.
- 评估治疗出现的不良事件 (TEAE),严重的TEAE (STEAE) 的发生率和LAI治疗的SCZ/SZA患者的死亡率.
- 分析因不良事件和因任何原因中止的治疗中止情况.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查和网络元分析.
- 包括的研究涉及诊断为SCZ或SZA的成年患者,将LAI与其他LAI或安慰剂进行比较.
- 主要结局集中在TEAE,STEAE和死亡;次要结局包括治疗中止.
主要成果:
- 分析了17个具有7,908名参与者的RCT.
- 在LAI和安慰剂之间没有观察到TEAE的显著差异.
- 与安慰剂相比,大多数LAI显示STEAE的风险较低,阿里皮普拉是例外.
- 除了哈洛佩里多尔外,其他抗药物显示出对因任何原因停止治疗的保护作用.
- 阿里皮普拉与因不良事件而导致停药的风险明显降低.
结论:
- 与安慰剂相比,LAI并没有显著增加一般TEAE的风险.
- 大多数 LAI 通过减少相对于安慰剂的 STEAEs,提供了显著的安全优势.
- 建议对抗精神病药物临床试验中的安全结果,特别是LAI的标准化报告准则,以提高元分析的准确性和减少偏见.
更多相关视频
相关概念视频
01:28Drug Therapy
45
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
45
01:21Antipsychotic Drugs: Typical and Atypical Agents
204
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...
204
01:26Psychosis: Goals of Pharmacotherapy
135
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.
135
01:28Psychosis and Antipsychotic Drugs: Overview
271
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...
271
01:19Pharmacovigilance
838
Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
838
01:21Antipsychotic Drugs: Therapeutic Uses and Side Effects
222
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...
222