从另一种第二代抗精神病药物换用阿立哌唑后代谢参数的变化：一项回顾性病历审查。

Changes in metabolic parameters with switching to aripiprazole from another second-generation antipsychotic: a retrospective chart review.

作者信息

Spurling Ronald D, Lamberti J Steven, Olsen David, Tu Xin, Tang Wan

机构信息

Department of Psychiatry, University of Rochester, Strong Memorial Hospital, Rochester, NY 14642, USA.

出版信息

J Clin Psychiatry. 2007 Mar;68(3):406-9. doi: 10.4088/jcp.v68n0308.

DOI:10.4088/jcp.v68n0308

PMID:17388710

Abstract

OBJECTIVE

This is a retrospective chart review of psychiatric outpatients switched to aripiprazole from another second-generation antipsychotic (SGA) examining whether metabolic parameters improved after the switch.

METHOD

Twenty-four psychiatric outpatients who had been switched to aripiprazole from another SGA were evaluated. Data were collected from October 6, 2004, until February 25, 2005, through review of medical records. Laboratory values and physical data were extracted to assess levels of fasting blood glucose, triglycerides, total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), and weight.

RESULTS

After switching to aripiprazole, total cholesterol was significantly decreased, with a mean (SD) difference of -28.8 (32.1) mg/dL (p = .001), and LDL was significantly decreased, with a mean (SD) difference of -20.75 (21.7) mg/dL (p = .0017). Weight was also significantly decreased, with a mean (SD) difference of -11.7 (16.6) lb (p = .003). There were no significant differences in HDL, triglycerides, or fasting blood glucose. When a subgroup of 15 patients switched from olanzapine to aripiprazole was examined separately, these changes were even more robust. In this subgroup, total cholesterol was significantly decreased, with a mean (SD) difference of -32.0 (35.6) mg/dL (p = .01). LDL was significantly decreased, with a mean (SD) difference of -21.6 (24.7) mg/dL (p = .011), and weight was significantly decreased, with a mean (SD) difference of -16.7 (14.7) lb (p < .001). Changes in total cholesterol, LDL, and HDL were not significantly different between subjects taking lipid-lowering medications and those not taking them.

CONCLUSION

Psychiatric outpatients switched to aripiprazole from another SGA showed a decrease in weight, total cholesterol, and LDL. Switching to aripiprazole, when clinically indicated, may lead to improvement in metabolic parameters associated with cardiovascular disease.

摘要

目的

这是一项针对从另一种第二代抗精神病药物（SGA）换用阿立哌唑的精神科门诊患者的回顾性病历审查，旨在研究换药后代谢参数是否有所改善。

方法

对24例从另一种SGA换用阿立哌唑的精神科门诊患者进行评估。通过查阅病历收集2004年10月6日至2005年2月25日的数据。提取实验室检查值和身体数据以评估空腹血糖、甘油三酯、总胆固醇、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）水平及体重。

结果

换用阿立哌唑后，总胆固醇显著降低，平均（标准差）差值为-28.8（32.1）mg/dL（p = 0.001），LDL也显著降低，平均（标准差）差值为-20.75（21.7）mg/dL（p = 0.0017）。体重也显著降低，平均（标准差）差值为-11.7（16.6）磅（p = 0.003）。HDL、甘油三酯或空腹血糖无显著差异。当单独检查从奥氮平换用阿立哌唑的15例患者亚组时，这些变化更为明显。在该亚组中，总胆固醇显著降低，平均（标准差）差值为-32.0（35.6）mg/dL（p = 0.01）。LDL显著降低，平均（标准差）差值为-21.6（24.7）mg/dL（p = 0.011），体重显著降低，平均（标准差）差值为-16.7（14.7）磅（p < 0.001）。服用降脂药物的患者与未服用降脂药物的患者在总胆固醇、LDL和HDL变化方面无显著差异。