卢拉西与用于精神分裂症的典型抗精神病药物相比
Dawid Storman1, Magdalena Koperny2, Krzysztof Styczeñ3
1Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland.
The Cochrane database of systematic reviews
|January 20, 2025
概括
这次审查发现,关于卢拉西与用于精神分裂症的典型抗精神病药物的证据非常不确定. 需要更多的大规模研究来澄清卢拉西在治疗精神分裂症中的益处和危害.
科学领域:
- 精神病学是一个精神病学.
- 临床药理学 临床药理学
背景情况:
- 抗精神病药物是精神分裂症治疗的基础.
- 虽然新一代的第二代抗精神病药物如卢拉西可用,但较旧的典型抗精神病药物仍然在全球广泛使用.
- 人们对较新和较老的抗精神病药物之间的风险益处概况的比较了解有限.
研究的目的:
- 在被诊断为精神分裂症或相关疾病的成年人中,系统地评估卢拉西与典型抗精神病药物相比的疗效和安全性.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查,将卢拉西与典型抗精神病药物进行比较.
- 搜索了多个数据库 (科克兰精神分裂症集团的基于研究的注册表,CENTRAL,MEDLINE,Embase) 和到2024年4月的试验注册.
- 评估偏差风险和证据确定性,使用GRADE对关键结果进行评估,包括精神状态,死亡率,生活质量和不良事件.
主要成果:
- 包括两项与308名参与者的RCT;223人接受了卢拉西,82人接受了典型的抗精神病药物 (haloperidol或perphenazine).
- 关于卢拉西对精神状态 (BPRS,PANSS) 的影响的证据非常不确定 (非常低确定性证据).
- 关于总体严重不良事件和严重不良事件的证据也非常不确定 (非常低的确定性证据).
结论:
- 与典型精神分裂症抗精神病药物相比,对于卢拉西对精神状态,严重不良事件或严重不良事件的益处存在重大不确定性.
- 目前的证据的确定性非常低,来自两个具有局限性的小型试验.
- 进一步的大规模随机对照试验对于阐明卢拉西与用于治疗精神分裂症的典型抗精神病药物的比较益处和危害至关重要.
更多相关视频
相关概念视频
01:21Antipsychotic Drugs: Typical and Atypical Agents
151
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...
151
01:21Antipsychotic Drugs: Therapeutic Uses and Side Effects
119
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...
119
01:28Psychosis and Antipsychotic Drugs: Overview
171
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...
171
01:28Drug Therapy
37
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
37
01:26Psychosis: Goals of Pharmacotherapy
103
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.
103
01:17Drugs for Treatment of Diarrhea-Predominant IBS
145
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
145