Packard Kathleen, Price Paul, Hanson Ashley
School of Pharmacy and Health Professions, Department of Pharmacy Practice, Creighton University, Omaha, NE, USA
School of Pharmacy and Health Professions, Department of Pharmacy Practice, Creighton University, Omaha, NE, USA.
J Pharm Pract. 2014 Oct;27(5):501-12. doi: 10.1177/0897190013516509. Epub 2014 Jan 15.
Rhabdomyolysis is not a well-understood adverse effect of antipsychotic use. Proposed mechanisms suggest involvement of serotoninergic and/or dopaminergic blockade. The purpose of this study was to describe the relationship between antipsychotic use and rhabdomyolysis. Patients admitted with rhabdomyolysis and taking an antipsychotic from January 2009 to October 2011 were included. Background demographics, laboratory data, medical and physical history, concomitant medications, and hospital course data were collected. Of the 673 cases admitted with rhabdomyolysis, 71 (10.5%) were on an antipsychotic. This is significantly greater when compared to the general US population, where only 1.3% of individuals take an antipsychotic drug (P < .0001). Cause of rhabdomyolysis was not documented in 38% of cases, and antipsychotic use was suspected in 10% of cases. No significant correlations were found between antipsychotic type and other patient-specific parameters. Seventeen (25%) of these patients were taking 2 or more antipsychotics. The largest percentage was on quetiapine (Seroquel(®); AstraZeneca, Wilmington, Delaware), the most commonly prescribed antipsychotic in the United States. Antipsychotic use is a risk factor for rhabdomyolysis and seems to be more common in those taking multiple agents. More research needs to be done to determine which antipsychotics have a higher risk and which receptors are involved. Providers should be aware of rhabdomyolysis associated with antipsychotic use.
横纹肌溶解症是抗精神病药物使用中一种尚未被充分理解的不良反应。提出的机制表明与5-羟色胺能和/或多巴胺能阻滞有关。本研究的目的是描述抗精神病药物使用与横纹肌溶解症之间的关系。纳入了2009年1月至2011年10月期间因横纹肌溶解症入院且正在服用抗精神病药物的患者。收集了背景人口统计学数据、实验室数据、病史和身体状况、伴随用药情况以及住院病程数据。在673例因横纹肌溶解症入院的病例中，71例（10.5%）正在服用抗精神病药物。与美国普通人群相比，这一比例显著更高，在美国普通人群中只有1.3%的人服用抗精神病药物（P <.0001）。38%的病例未记录横纹肌溶解症的病因，10%的病例怀疑与抗精神病药物使用有关。未发现抗精神病药物类型与其他患者特定参数之间存在显著相关性。这些患者中有17例（25%）正在服用2种或更多种抗精神病药物。服用喹硫平（思瑞康®；阿斯利康公司，特拉华州威尔明顿）的比例最高，喹硫平是美国最常用的抗精神病药物。使用抗精神病药物是横纹肌溶解症的一个危险因素，在服用多种药物的患者中似乎更为常见。需要进行更多研究以确定哪些抗精神病药物风险更高以及涉及哪些受体。医疗服务提供者应意识到与抗精神病药物使用相关的横纹肌溶解症。
