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使用in silico方法来确定基于decanoate的长效注射精神病药物的最佳逐渐缩减方案
James R O'Neill1, David M Taylor2, Mark A Horowitz3
1Faculty of Medicine and Health, University of Leeds, LS2 9JT, UK.
Therapeutic advances in psychopharmacology
|September 16, 2024
概括
逐渐减少长效可注射多巴胺抗剂 (LIDA) 使用过度的原则可以最大限度地减少戒断和复发风险. 完全停止治疗需要切换到口服配方,以保持逐步减少D2占用.
科学领域:
- 心理药理学 心理药理学
- 神经科学是一个神经科学.
- 临床药房 临床药房
背景情况:
- 对于逐渐减少基于达诺酸的长效可注射多巴胺抗剂 (LIDA) 存在有限的指导.
- 逐渐降低剂量可以尽量减少戒断效应和精神病治疗中复发风险.
研究的目的:
- 应用超标渐变原理对基于十酸盐的LIDA (flupentixol,zuclopenthixol,haloperidol) 的使用.
- 为这些长效注射药物制定基于证据的戒断方案.
主要方法:
- 血中药物度和D2受体占用率的模拟.
- 利用现有的药理动力学和神经成像数据.
- 模拟剂量减少,限制每月D2占用率的变化 (10%, 5%, 2.5%).
主要成果:
- 突然停止LIDA治疗会导致过度的D2占用变化,冒着戒断和复发的风险.
- 通过过度降低剂量,可以实现逐渐的血水平和D2占用率下降.
- 更频繁的LIDA管理允许更慢的D2占用率减少.
结论:
- 十酸性LIDA的突然停止与过度缩小的逐渐缩小不相容.
- 切换到口服抗精神病药物是必要的完整的过度缩小.
- 需要进一步的现实研究来验证in silico发现.
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