Wang Hee Ryung, Woo Young Sup, Bahk Won-Myong
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Int Clin Psychopharmacol. 2016 Nov;31(6):301-6. doi: 10.1097/YIC.0000000000000135.
This systematic review aims to investigate whether melatonin or melatonin agonists significantly attenuate metabolic side effects among psychiatric populations treated with atypical antipsychotics. Four randomized-controlled trials were identified through a comprehensive literature search using MEDLINE, EMBASE, and the Cochrane Library on 22 October 2015. These four trials (including three melatonin studies and one ramelteon study) included 138 patients, of whom 71 were treated with melatonin or ramelteon and 67 were treated with a placebo. Because of high heterogeneity, we did not carry out a meta-analysis. Melatonin was beneficial in lowering blood pressure among bipolar disorder patients; this blood pressure-lowering effect was not prominent among schizophrenic patients. Melatonin appeared to improve lipid profiles and body composition and attenuated weight gain among both schizophrenic and bipolar disorder patients. Ramelteon showed a significant efficacy in lowering total cholesterol level. Despite the few studies included, this systematic review provided promising evidence of the potential benefits of melatonin and its agonists in attenuating one or more components of metabolic syndrome among psychiatric patients using atypical antipsychotics.
本系统评价旨在研究褪黑素或褪黑素激动剂是否能显著减轻接受非典型抗精神病药物治疗的精神疾病患者的代谢副作用。通过2015年10月22日使用MEDLINE、EMBASE和Cochrane图书馆进行的全面文献检索，确定了四项随机对照试验。这四项试验（包括三项褪黑素研究和一项雷美替胺研究）共纳入138例患者，其中71例接受褪黑素或雷美替胺治疗，67例接受安慰剂治疗。由于异质性较高，我们未进行荟萃分析。褪黑素对降低双相情感障碍患者的血压有益；这种降压作用在精神分裂症患者中并不突出。褪黑素似乎能改善脂质谱和身体成分，并减轻精神分裂症和双相情感障碍患者的体重增加。雷美替胺在降低总胆固醇水平方面显示出显著疗效。尽管纳入的研究较少，但本系统评价提供了有前景的证据，表明褪黑素及其激动剂在减轻使用非典型抗精神病药物的精神疾病患者代谢综合征的一个或多个组成部分方面具有潜在益处。
