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酒精使用障碍识别测试(AUDIT)评分在抗精神病药引起的高催乳素血症中升高。

Alcohol Use Disorders Identification Test (AUDIT) scores are elevated in antipsychotic-induced hyperprolactinaemia.

机构信息

Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.

出版信息

J Psychopharmacol. 2012 Feb;26(2):324-9. doi: 10.1177/0269881110393051. Epub 2011 Jan 24.

Abstract

Hyperprolactinaemia in antipsychotic treated patients with schizophrenia is a consequence of D2 receptor (DRD2) blockade. Alcohol use disorder is commonly comorbid with schizophrenia and low availability of striatal DRD2 may predispose individuals to alcohol use. In this pilot study we investigated whether hyperprolactinaemia secondary to pharmacological DRD2 blockade was associated with alcohol use disorder in 219 (178 males and 41 females) patients with schizophrenia. Serum prolactin determinations were made in patients diagnosed with schizophrenia and maintained on antipsychotic agents. Clinical assessment included demographics, family history and administration of the AUDIT (Alcohol Use Disorders Identification Test). Higher AUDIT scores were associated with prolactin-raising antipsychotic medication (n=106) compared with prolactin-sparing medication (n=113). Risperidone (n=63) treated patients had higher AUDIT scores and prolactin levels than those on other atypical antipsychotics (n = 113). Across the entire sample, patients with a prolactin greater than 800 mIU/L had higher AUDIT scores and were more likely to exceed the cut-off score for harmful and hazardous alcohol use. These differences were not explained by potential confounds related to clinical features and demographics, comorbidity or medication side-effects. These data suggest that by lowering dosage, or switching to another antipsychotic agent, the risk for alcohol use disorder in those with schizophrenia may be reduced. This hypothesis requires testing using a prospective methodology.

摘要

抗精神病药物治疗的精神分裂症患者出现高催乳素血症是 D2 受体(DRD2)阻断的结果。酒精使用障碍通常与精神分裂症共病,纹状体 DRD2 的低可用性可能使个体易患酒精使用。在这项初步研究中,我们调查了 219 名(178 名男性和 41 名女性)精神分裂症患者中,由于药物性 DRD2 阻断引起的高催乳素血症是否与酒精使用障碍有关。在被诊断患有精神分裂症并接受抗精神病药物治疗的患者中进行血清催乳素测定。临床评估包括人口统计学、家族史和 AUDIT(酒精使用障碍识别测试)的管理。与使用催乳素保留药物(n=113)相比,催乳素升高的抗精神病药物(n=106)与更高的 AUDIT 评分相关。与其他非典型抗精神病药物(n=113)相比,服用利培酮(n=63)的患者的 AUDIT 评分和催乳素水平更高。在整个样本中,催乳素大于 800 mIU/L 的患者的 AUDIT 评分更高,更有可能超过有害和危险饮酒的临界值。这些差异不能用与临床特征、人口统计学、共病或药物副作用相关的潜在混杂因素来解释。这些数据表明,通过降低剂量或改用另一种抗精神病药物,精神分裂症患者发生酒精使用障碍的风险可能会降低。这一假设需要使用前瞻性方法进行测试。

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