在患有精神分裂症谱系障碍的患者中,ADHD药物的长期安全性
Jurjen J Luykx1,2,3,4, Olivier Corbeil5,6, Olli Kärkkäinen7
1Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands. j.j.luykx@amsterdamumc.nl.
Molecular psychiatry
|July 2, 2025
概括
注意缺陷多动症 (ADHD) 药物,特别是利兹胺,对于精神分裂症谱系障碍 (SSD) 患者来说似乎比以前认为的更安全. 建议仔细考虑好处与风险,以改善患者的康复.
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.
- 公共卫生 公共卫生
背景情况:
- 注意缺陷多动障碍 (ADHD) 经常与精神分裂症谱系障碍 (SSD) 一起发生.
- 在SSD患者中,并发性ADHD与较差的临床结果有关.
- 安全问题在历史上限制了SSD人群的药理学ADHD治疗.
研究的目的:
- 在被诊断为SSD的个体中调查ADHD药物的安全性.
- 评估ADHD药物使用与精神病,心血管和医疗结果之间的关联.
- 为了告知临床决策有关ADHD治疗在伴并发性SSD患者.
主要方法:
- 对131,476名SSD患者进行了一项大型队列研究.
- 在个体内使用考克斯回归分析来计算调整的危险比率 (aHR).
- 结果包括全因住院/死亡率,精神病住院,体质住院和心血管住院.
主要成果:
- 利斯德甲胺使用与全因住院/死亡率 (aHR=0.89) 和体质住院 (aHR=0.70) 的减少有关.
- 甲基酸盐显示,全因住院/死亡风险略有增加 (aHR=1.04),特别是在高剂量或没有抗精神病药时.
- 阿托莫克西丁与精神病住院率的减少有关 (aHR=0.87);ADHD多疗法增加了体质住院风险 (aHR=1.37).
结论:
- 在SSD患者中,使用ADHD药物,特别是lisdexamphetamine和某些甲基胺疗法,通常比预想的更安全.
- 对于甲基酸盐和利斯德克萨胺,关于住院和精神病风险的U形剂量反应曲线被观察到.
- 共享决策至关重要,以平衡ADHD治疗的好处与改善SSD患者康复的风险.
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