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首页> 外文期刊>The journal of clinical psychiatry >Metabolic considerations in the use of antipsychotic medications: a review of recent evidence.
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Metabolic considerations in the use of antipsychotic medications: a review of recent evidence.

机译：抗精神病药物使用中的代谢注意事项：最新证据综述。

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Compared with the general population, persons with schizophrenia have up to a 20% shorter lifespan, with cardiovascular disease as the leading cause of death. In addition, persons with schizophrenia have increased prevalence of the metabolic syndrome (obesity, insulin resistance, dyslipidemia, impaired glucose tolerance, and hypertension), increased prevalence of risk factors such as smoking, poverty, and poor nutrition, and reduced access to medical care. Results from the recent Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) provide further evidence of the metabolic risk associated with different atypical antipsychotics. Based on this study and a growing number of other randomized clinical trials, clozapine and olanzapine treatment can produce substantial mean changes in weight and an increased risk of associated metabolic disturbances. Risperidone and quetiapine treatment can produce intermediate changes in mean weight in comparison to treatment with other atypical antipsychotics, with discrepant results with respect to metabolic risk. Aripiprazole and ziprasidone treatment induced the lowest mean changes in weight gain and had no effect on risk for adverse metabolic changes, among currently available atypical agents. Considerable evidence indicates that mentally ill patients often do not receive adequate recognition of, monitoring of, or care for their medical illnesses. There is a critical need for psychiatrists and primary care professionals to increase awareness of and attention to the physical health problems of persons with mental illness, including appropriate management of metabolic adverse events associated with psychiatric medications.
机译：与普通人群相比，精神分裂症患者的寿命缩短了20％，其中心血管疾病是主要的死亡原因。此外，精神分裂症患者的代谢综合征（肥胖，胰岛素抵抗，血脂异常，葡萄糖耐量降低和高血压）的患病率增加，吸烟，贫穷和营养不良等危险因素的患病率增加，就医机会减少。最近的临床抗精神病药物干预有效性试验（CATIE）的结果提供了与不同的非典型抗精神病药物有关的代谢风险的进一步证据。根据这项研究和越来越多的其他随机临床试验，氯氮平和奥氮平治疗可引起体重的显着平均变化并增加相关代谢紊乱的风险。与使用其他非典型抗精神病药治疗相比，利培酮和喹硫平治疗可产生平均体重的中间变化，在代谢风险方面存在差异。在目前可用的非典型药物中，阿立哌唑和齐拉西酮治疗引起的体重增加平均变化最低，对不良代谢变化的风险没有影响。大量证据表明，精神病患者常常无法充分认识，监测或护理他们的医学疾病。精神科医生和初级保健专业人员迫切需要提高对精神疾病患者身体健康问题的认识和关注，包括适当管理与精神药物有关的代谢不良事件。

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