在精神分裂症患者的口服后突触性抗多巴胺激素抗精神病药物之间切换的策略:系统性审查
Christoph U Correll1,2,3,4
1Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, 75-59 263rd St, Glen Oaks, NY, 11004, USA. ccorrell@northwell.edu.
CNS drugs
|July 23, 2025
概括
抗精神病药物切换在精神分裂症治疗中很常见. 从临床上来说,逐渐切换是最好的,以避免戒断症状,尽管比较特定策略的研究仍然有限.
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.
背景情况:
- 抗精神病药物切换是精神分裂症管理中的常见临床实践.
- 了解药理动力学和药理动力学特性对于有效的抗精神病药物转换策略至关重要.
- 在具有不同半衰期或受体配置的药物之间切换可以加速戒断或反弹症状.
研究的目的:
- 系统地审查关于在精神分裂症和精神分裂情绪障碍的口服抗精神病药物之间切换策略的研究.
- 提取和分析影响抗精神病药物转换结果的药理动力学和药理动力学特征.
主要方法:
- 对MEDLINE,Embase,Cochrane和PubMed数据库的系统文献综述 (2010年6月至2024年4月).
- 包括随机对照试验,开放标签研究,元分析和口服抗精神病药物切换的评论.
- 排除了长效注射剂,未经批准的抗精神病药物或其他疾病的研究.
主要成果:
- 确定了80篇关于精神分裂症口服抗精神病药物转换的文章,包括58项研究和22篇评论/元分析.
- 交叉定位是最常见的切换方法 (69.6%),而突然切换是罕见的.
- 很少有研究在统计学上比较不同的切换策略,产生混合的结果;镇静剂救援治疗数据往往未披露.
结论:
- 尽管经常使用,但很少有研究专门研究不同抗精神病药物切换策略的结果.
- 临床实践通常倾向于逐步切换以减轻潜在的戒断和反弹症状.
- 需要进一步研究切换当前和新兴抗精神病药物,特别是那些具有不同受体配置的抗精神病药物.
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