Baranyi Andreas, Yazdani Renè, Haas-Krammer Alexandra, Stepan Alexandra, Kapfhammer Hans-Peter, Rothenhäusler Hans-Bernd
Universitätsklinik für Psychiatrie Graz, Medizinische Universität Graz, Graz, Osterreich.
Wien Med Wochenschr. 2007;157(11-12):255-70. doi: 10.1007/s10354-007-0379-9.
The introduction of atypical antipsychotics in psychopharmacology represented a major advance in the treatment of psychotic disorders. However, there have been numerous studies that certain atypical antipsychotics may be associated with a greater risk of metabolic abnormalities than others, including weight gain, hyperlipidemia and new-onset typ 2 diabetes mellitus. A G-Protein beta3 subunit Gen (C825T) polymorphism, an increased carbohydrate metabolism and dyshormonism are discussed as pathogenetic mechanisms. High risk patients (adiposity, hyperlipidaemia, hyperglycaemia, preexisting diabetes) should maintain an antipsychotic agent with a favourable side effect profile. In these cases a periodical diabetes screening and blood lipid controls are required. Clinicans must balance the significant benefits of atypical antipsychotics against the risk of metabolic disturbances. In this article recent findings are reviewed.
非典型抗精神病药物在精神药理学中的引入代表了精神病性障碍治疗的一项重大进展。然而,有大量研究表明,某些非典型抗精神病药物可能比其他药物具有更高的代谢异常风险,包括体重增加、高脂血症和新发2型糖尿病。G蛋白β3亚基基因(C825T)多态性、碳水化合物代谢增加和内分泌失调被认为是发病机制。高危患者(肥胖、高脂血症、高血糖、既往糖尿病)应选用具有良好副作用谱的抗精神病药物。在这些情况下,需要定期进行糖尿病筛查和血脂控制。临床医生必须在非典型抗精神病药物的显著益处与代谢紊乱风险之间取得平衡。本文对近期研究结果进行了综述。