在痴呆症中中止抗精神病药物的系统审查和元分析
Sophie Roche1,2, Nimesh Naran1, Janneke Scholtz1
1North London NHS Foundation Trust St Pancras Hospital London England.
Alzheimer's & dementia (New York, N. Y.)
|December 17, 2025
概括
在痴呆症患者中停止服用抗精神病药物会增加52%的复发风险. 复发风险不受试验设计,治疗持续时间或戒断速度的影响,这凸显了对一些人继续服用药物的仔细考虑的必要性.
科学领域:
- 老年精神病学是一门精神病学专业.
- 心理药理学 心理药理学
- 基于证据的医学 基于证据的医学
背景情况:
- 抗精神病药物用于痴呆症 (BPSD) 的行为和心理症状,但具有不良结果的风险.
- 之前的审查表明,在停止服用抗精神病药物后,关于复发风险的证据质量不佳.
- 进行了一项元分析,以确定痴呆症患者在停止服用抗精神病药物后出现症状复发的综合风险比率 (RR).
研究的目的:
- 在痴呆症中进行抗精神病药物戒断试验的元分析.
- 调查影响复发风险的因素,包括试验设计,治疗持续时间和戒断速度.
主要方法:
- 在PsycINFO,EMBASE,PubMed和ClinicalTrials.gov (2018年1月至2024年6月) 的系统搜索.
- 包括来自2018年Cochrane审查的研究.
- 使用随机效应模型进行元分析,以计算复发的聚合RR.
主要成果:
- 包括9项研究,包括682个观察结果和135个事件.
- 停用抗精神病药物导致复发的综合RR为1.52 (95%CI:1.18至1.95,p=0.005).
- 超回归表明,试验类型,退出速度,随访时间或参与者的性别对复发风险没有显著影响.
结论:
- 复发风险的显著增加与痴呆症患者中断抗精神病药物有关.
- 试验设计,治疗持续时间和戒断速度并没有显著改变复发风险.
- 需要进一步的研究来确定抗精神病药物成功戒断的预测因素,因为一些患者可能会从持续的药物治疗中受益.
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