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选择性5-羟色胺再摄取抑制剂类抗抑郁药会增加服用抗精神病药物患者锥体外系副作用的风险吗?

Do SSRI Antidepressants Increase The Risk of Extrapyramidal Side Effects In Patients Taking Antipsychotics?

作者信息

Allsbrook Matthew, Fries Brant E, Szafara Kristina L, Regal Randolph E

出版信息

P T. 2016 Feb;41(2):115-9.

Abstract

PURPOSE

Among antidepressants, selective serotonin reup-take inhibitors (SSRIs) have enjoyed great popularity among clinicians as well as generally wide acceptance and tolerance among patients. A potentially overlooked side effect of SSRIs is the occasional occurrence of extrapyramidal symptoms (EPS), which could be a concern when SSRIs are used with antipsychotics. This study was designed to explore the possible association between SSRI antidepressant use and the incidence of EPS side effects in patients who take concomitant antipsychotic medications.

METHODS

The University of Michigan conducted a study at the four Michigan state mental health hospitals between May 2010 and October 2010. The Michigan Public Health Institute collected data using the InterRAI Mental Health Assessment (InterRAI MH). The present study is a retrospective cohort analysis of the cross-sectional data that were collected. Within these institutions, 693 residents were using antipsychotics. We measured the observed frequency of seven EPS recorded in the InterRAI MH within three groups of patients: 1) those on antipsychotic drugs who were taking an SSRI antidepressant; 2) those on antipsychotic drugs who were not taking an antidepressant; and 3) those on antipsychotic drugs who were taking a non-SSRI antidepressant. Differences in the prevalence of EPS were tested using one-way analysis of variance.

RESULTS

There were no significant differences in the observed EPS frequencies among the three groups (F 2,18 = 0.01; P < 0.9901).

CONCLUSION

In this study, SSRIs did not appear to potentiate the occurrence of EPS in patients using antipsychotics.

摘要

目的

在抗抑郁药中,选择性5-羟色胺再摄取抑制剂(SSRI)在临床医生中广受欢迎,并且在患者中普遍被接受且耐受性良好。SSRI一个可能被忽视的副作用是偶尔会出现锥体外系症状(EPS),当SSRI与抗精神病药物联用时,这可能是一个需要关注的问题。本研究旨在探讨使用SSRI抗抑郁药与同时服用抗精神病药物的患者发生EPS副作用之间的可能关联。

方法

密歇根大学于2010年5月至2010年10月在密歇根州的四家州立精神卫生医院进行了一项研究。密歇根公共卫生研究所使用相互关系机构间精神卫生评估(InterRAI MH)收集数据。本研究是对所收集的横断面数据进行的回顾性队列分析。在这些机构中,693名住院患者正在使用抗精神病药物。我们测量了三组患者在InterRAI MH中记录的七种EPS的观察频率:1)正在服用抗精神病药物且同时服用SSRI抗抑郁药的患者;2)正在服用抗精神病药物但未服用抗抑郁药的患者;3)正在服用抗精神病药物且服用非SSRI抗抑郁药的患者。使用单因素方差分析测试EPS患病率的差异。

结果

三组患者观察到的EPS频率没有显著差异(F 2,18 = 0.01;P < 0.9901)。

结论

在本研究中,SSRI似乎并未增强使用抗精神病药物患者中EPS的发生。

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