抗精神病的血度作为运动障碍和心脏代谢副作用的预测指标:与处方剂量的比较
Yinzhao Liu1, Iris E Sommer1, Georgios Schoretsanitis2
1Centers for Clinical Neuroscience and Cognition, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands.
抗精神病药物 (AP) 的血度在第一发精神病 (FEP) 患者中比剂量更好地预测帕金森症. 然而,治疗药物监测 (TDM) 对于APs对于心脏代谢副作用并不有用.
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
- 神经科学是一个神经科学.
背景情况:
- 对抗精神病 (AP) 治疗药物监测 (TDM) 在管理与AP相关的运动障碍和心脏代谢副作用方面的临床证据不一致.
- 了解AP血度,剂量和副作用之间的关系对于优化患者护理至关重要.
研究的目的:
- 评估AP的血度如何与第一发精神病 (FEP) 患者的运动障碍和心脏代谢副作用随着时间的推移相关.
- 为了比较这些副作用的AP血度与处方剂量的预测值.
主要方法:
- 对来自HAMLETT试验的200名FEP患者进行分析,并对标准化AP血度 (z-score) 进行分析.
- 使用圣汉斯评分表和巴恩斯阿卡西西亚评分表对运动障碍的评估.
- 用混合效应模型和贝叶斯信息标准 (BIC) 进行心脏代谢指数和纵向关联的评估,以进行预测值比较.
主要成果:
- 血中的AP度与帕金森症 (OR = 1.81,p = 0.001) 有积极关联,但与其他运动障碍或心脏代谢指数无关.
- AP的血度比处方剂量更有效地预测了帕金森症 (ΔBIC = -2.95).
- 处方剂量显示出比AP血度更好地预测腰围和胆固醇水平.
结论:
- 在FEP缓解患者中,AP TDM可能比剂量更有价值,用于评估帕金森症,因为药物水平在点受体上更接近.
- 在这个人群中,AP TDM对监测心脏代谢副作用似乎没有用处.
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