Juruena Mario F, de Sena Eduardo Pondé, de Oliveira Irismar Reis
Stress and Affective Disorders Programme, Department of Neuroscience and Behaviour, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil;
Drug Healthc Patient Saf. 2010;2:205-11. doi: 10.2147/DHPS.S6226. Epub 2010 Oct 1.
The introduction of the atypical antipsychotic drugs represents an important advance in the treatment of schizophrenia, because the therapeutic efficacy, tolerability, and safety profiles of these agents seem to be superior to that of the classical neuroleptics. As would be predicted from the pharmacologic profile of a pure D(2)/D(3) receptor blocker, amisulpride is an atypical antipsychotic agent, effective for positive and negative symptoms, which can bring about additional improvement in the social functioning and quality of life of patients with schizophrenia. Amisulpride is effective in acute schizophrenia as determined by Clinical Global Impression scores. The major concern regarding the safety of the atypical antipsychotics is related to their propensity to induce weight gain and alter glucose and lipid metabolism. Amisulpride has one of the lowest potentials for weight gain of all the antipsychotic agents, and is associated with clearly lower use of antiparkinsonian medication and with fewer dropouts due to adverse events than conventional antipsychotics. Amisulpride is well tolerated with regard to anxiety and insomnia, and not notably different from placebo. Amisulpride has a pronounced prolactin-elevating effect which appears to be independent of dosage and duration of administration. Hyperprolactinemia rapidly reverses following amisulpride discontinuation. Amisulpride benefits patients with negative symptoms, and is the only antipsychotic to demonstrate efficacy in patients with predominantly negative symptoms. Amisulpride maintains its efficacy when used for medium/long-term treatment, as demonstrated in studies of up to 12 months. In terms of relevance of the effects, superiority is observed for quality of life, social adaptation, and functioning, as measured by the Quality of Life and Functional Status Questionnaire scales. In conclusion, amisulpride is an antipsychotic agent with proven efficacy and good tolerability. Moreover, this drug can help people with schizophrenia to attain social reinsertion.
非典型抗精神病药物的引入是精神分裂症治疗的一项重要进展，因为这些药物的治疗效果、耐受性和安全性似乎优于传统抗精神病药物。正如从纯D(2)/D(3)受体阻滞剂的药理学特征所预测的那样，氨磺必利是一种非典型抗精神病药物，对阳性和阴性症状均有效，可进一步改善精神分裂症患者的社会功能和生活质量。根据临床总体印象评分，氨磺必利对急性精神分裂症有效。关于非典型抗精神病药物安全性的主要担忧与其导致体重增加以及改变葡萄糖和脂质代谢的倾向有关。氨磺必利是所有抗精神病药物中体重增加潜力最低的药物之一，与传统抗精神病药物相比，其抗帕金森药物的使用明显减少，因不良事件导致的停药情况也较少。氨磺必利在焦虑和失眠方面耐受性良好，与安慰剂无明显差异。氨磺必利具有明显的催乳素升高作用，这似乎与剂量和给药持续时间无关。停用氨磺必利后，高催乳素血症会迅速逆转。氨磺必利对阴性症状患者有益，是唯一在以阴性症状为主的患者中显示出疗效的抗精神病药物。如长达12个月的研究所表明，氨磺必利用于中长期治疗时仍保持其疗效。就效果的相关性而言，根据生活质量和功能状态问卷量表测量，在生活质量、社会适应和功能方面观察到其具有优越性。总之，氨磺必利是一种疗效已得到证实且耐受性良好的抗精神病药物。此外，这种药物可以帮助精神分裂症患者重新融入社会。
