Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Expert Rev Neurother. 2011 Jul;11(7):989-1006. doi: 10.1586/ern.11.82.
Adverse metabolic events, such as increased adiposity, hyperglycemia, diabetes mellitus and dyslipidemia, have been associated with treatment using atypical antipsychotic medications. However, the complexity of some of the reports on this problem and marketing efforts in this area may make it difficult for psychiatrists to remain fully and accurately informed about the metabolic complications of atypical antipsychotic therapy. Little is currently known about how psychiatrists view what they have read or heard, how they perceive the available information and how this affects their management of patients with schizophrenia. A number of studies have demonstrated that nonadherence to the medication regimen in schizophrenia is associated with poor symptomatic outcome, increased risk of relapse, more frequent use of compulsory treatment and increased risk of suicide and severe self-harm. Suicide is a major cause of death among schizophrenic patients, and their attitude toward medication can make the difference between a proper therapeutic regimen that protects patients from suicide risk versus discontinuation of treatments that are associated with disabling symptoms, some of which are risk factors for suicide. We review the characteristics of a new drug, asenapine, that may improve adherence in patients as a result of a distinctive receptor profile that may be associated with fewer side effects than other second-generation antipsychotic drugs.
不良代谢事件，如肥胖、高血糖、糖尿病和血脂异常，与使用非典型抗精神病药物治疗有关。然而，由于该问题的一些报告比较复杂，且该领域的营销力度较大，精神科医生可能难以全面、准确地了解非典型抗精神病药物治疗的代谢并发症。目前，我们对精神科医生如何看待他们所读到或听到的内容、如何看待现有信息以及这如何影响他们对精神分裂症患者的治疗知之甚少。许多研究表明，精神分裂症患者不遵医嘱服药与症状改善不佳、复发风险增加、更频繁地使用强制性治疗以及自杀和严重自残风险增加有关。自杀是精神分裂症患者的主要死因，他们对药物的态度可能会影响到保护患者免受自杀风险的适当治疗方案与可能导致致残症状的治疗方案之间的区别，而一些致残症状是自杀的风险因素。我们回顾了一种新药阿塞那平的特点，由于其独特的受体特征，它可能会提高患者的服药依从性，从而减少与其他第二代抗精神病药物相比可能更少的副作用。
