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Risks and benefits of bupropion treatment in schizophrenia: A systematic review of the current literature

机译：中产阶级治疗在精神分裂症中的风险和益处：对目前文学的系统综述

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摘要

BACKGROUND: Bupropion inhibits the reuptake of norepinephrine and dopamine, which are involved in the pathogenesis of affective, cognitive, and psychomotor impairment in schizophrenia. Because of reports on bupropion-associated psychoses, it is reluctantly used in schizophrenic patients. Risks and benefits, however, have never been comprehensively reviewed. OBJECTIVE: The objectives of this study were to evaluate the efficacy of bupropion on depression, negative symptoms, cognition, and smoking habits in schizophrenia and to appraise safety aspects. METHODS: MEDLINE OVID/PubMed, scholar.google.com and the Cochrane Database were screened for the keywords ("bupropion"/ "wellbutrin"/"elontril"/"zyban") and ("psychosis"/"schizophrenia"/"psychotic disorder"). STUDY SELECTION: A total of 13 randomized controlled trials (28 publications), 3 open prospective evaluations, 5 multiple case reports, 22 single case reports, and 6 review articles were incorporated in the final analysis. DATA EXTRACTION: Information on patient population, age, diagnosis, bupropion dose and formulation, antipsychotic and concomitant medication, adverse events and treatment outcomes regarding psychosis, affective and negative symptoms, cognition, and smoking habits were collected from the published reports. RESULTS: A total of 30 cases of bupropion-induced psychoses have been published, 17 (57%) of which were associated with the immediate-release drug formulation and 28 (93%) of which occurred without concomitant antipsychotic medication. In comparison, 229 schizophrenic patients on stable antipsychotic regimens were successfully treated with bupropion and experienced marked clinical improvement without developing psychosis. Pharmacokinetic interactions with antipsychotics were rare, whereas electroencephalographic abnormalities occurred frequently. CONCLUSIONS: In schizophrenic patients treated with bupropion in addition to antipsychotics, the risk for bupropion-induced psychoses seems negligible. The efficacy of a combined dopamine and norepinephrine agonist in schizophrenia is biologically plausible. Further trials involving bupropion should integrate neurobiological methods and focus on negative symptoms and cognitive deficits in schizophrenia.
机译：背景：Bupropion抑制了去甲肾上腺素和多巴胺的再摄取，这参与了精神分裂症的情感，认知和精神运动障碍的发病机制。由于关于Buroprop相关的精神上的报告，它不情愿地用于精神分裂症患者。然而，从未完全审查过风险和福利。目的：本研究的目的是评估Bupropion对精神分裂症中的抑郁，阴性症状，认知和吸烟习惯的疗效，并评估安全方面。方法：Medline Ovid / PubMed，Scholar.Google.com和Cochrane数据库被筛选为关键字（“Bupropion”/“Wellbutrin”/“Elontril”/“Zyban”）和（“精神病”/“精神分裂症”/“精神病紊乱”）。学习选择：共有13项随机对照试验（28个出版物），3个开放的前瞻性评估，5个多案报告，22个单案报告，6条审查文章纳入最终分析。数据提取：有关患者人口，年龄，诊断，Bupropion剂量和制剂的信息，从公布的报告中收集了有关精神病，情感和消极症状，认知和吸烟习惯的抗精神病药和伴随药物，抗精神病药和伴随药物，不良事件和治疗结果。结果：公布了30例Bupropion诱导的手淫，其中17例（57％）与直接释放药物制剂相关，其中28（93％），其中没有伴随的抗精神病药。相比之下，成功地治疗了229例稳定抗精神病药方案的患者，并经历了明显的临床改善而不发展精神病。与抗精神病药的药代动力学相互作用罕见，而脑电图常见发生。结论：除了抗精神病药外，在抗肌无缩治疗的精神分裂症患者中，Bupropion诱导的肌肉的风险似乎可忽略不计。组合多巴胺和去甲肾上腺素激动剂在精神分裂症中的疗效是生物合理的。涉及Bupropion的进一步试验应整合神经生物学方法，并专注于精神分裂症中的消极症状和认知缺陷。

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  • 来源
    《Clinical neuropharmacology》 |2013年第6期|共13页
  • 作者

    EnglischS.; MorgenK.; Meyer-LindenbergA.; ZinkM.;

  • 作者单位

    Department of Psychiatry and Psychotherapy Central Institute of Mental Health University of;

    Department of Psychiatry and Psychotherapy Central Institute of Mental Health University of;

    Department of Psychiatry and Psychotherapy Central Institute of Mental Health University of;

    Department of Psychiatry and Psychotherapy Central Institute of Mental Health University of;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 药理学;
  • 关键词

    bupropion; depression; dopamine; psychosis; schizophrenia;

    机译：Bupropion;抑郁;多巴胺;精神病;精神分裂症;

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