Department of Mental Health, ASL Salerno 1, Mental Health Center n 4, Piazza Galdi, 841013 Cava de’ Tirreni (Salerno), Italy.
Neuropsychiatr Dis Treat. 2009;5:117-25. doi: 10.2147/ndt.s4167. Epub 2009 Apr 8.
Aripiprazole is a relatively novel second-generation antipsychotic belonging to the chemical class of benzisoxazole derivatives and is characterized by a unique pharmacological profile which suggests that the drug acts as a dopamine-serotonin system stabilizer. Whereas all previously available antipsychotics are antagonists at D(2) receptors, aripiprazole is the only available partial agonist at these receptors. Thus, it has been suggested that aripiprazole could be associated with a relatively neutral impact on bodyweight, possibly reducing risks of a detrimental impact on the quality of life that often complicates management for a large number of patients diagnosed with severe and persistent mental disorders (SPMDs) treated chronically with antipsychotic medications. However, data from short- and long-term reviewed studies indicate that the prevalence rate of clinically relevant weight gain during therapy with this drug is similar to that occurring during treatments with other antipsychotic agents, either typical or atypical. Moreover, information on the impact of aripiprazole therapy on the quality of life of patients diagnosed with SPMDs is scarce and characterized by conflicting results. Given these results, further, large, well-designed studies are needed before confirming potential advantages of aripiprazole over first-generation antipsychotics and other SGAs.
阿立哌唑是一种相对较新的第二代抗精神病药物,属于苯并异恶唑衍生物化学类别,其独特的药理学特征表明,该药物具有多巴胺-血清素系统稳定剂的作用。虽然所有以前可用的抗精神病药物都是 D2 受体拮抗剂,但阿立哌唑是这些受体的唯一可用部分激动剂。因此,有人认为阿立哌唑可能与体重的相对中性影响有关,可能降低了经常使大量被诊断患有严重和持续性精神障碍(SPMD)的患者的治疗复杂化的生活质量受损的风险,这些患者长期接受抗精神病药物治疗。然而,来自短期和长期综述研究的数据表明,在该药物治疗期间出现临床相关体重增加的患病率与在使用其他抗精神病药物(典型或非典型)治疗期间发生的体重增加患病率相似。此外,关于阿立哌唑治疗对被诊断为 SPMD 的患者生活质量的影响的信息很少,并且结果存在冲突。鉴于这些结果,在确认阿立哌唑相对于第一代抗精神病药物和其他 SGA 的潜在优势之前,需要进一步进行大型、精心设计的研究。