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棕榈酸帕利哌酮:疗效、安全性及在精神分裂症治疗中的应用

Paliperidone palmitate: effectiveness, safety, and the use for treatment of schizophrenia.

作者信息

Jarema Marek, Bieńkowski Przemysław, Heitzman Janusz, Parnowski Tadeusz, Rybakowski Janusz

机构信息

III Klinika Psychiatryczna IPiN w Warszawie.

Zakład Farmakologii Doświadczalnej i Klinicznej IPiN w Warszawie.

出版信息

Psychiatr Pol. 2017 Feb 26;51(1):7-21. doi: 10.12740/PP/64581.

Abstract

The aim of the study was to summarize the efficacy and tolerability of paliperidone palmitate, an atypical long-acting antipsychotic drug. Paliperidone is a 9-hydroxy metabolite of risperidone with a slightly different receptor profile and significantly different pharmacokinetic profile. After the short review of its pharmacological properties, the efficacy of the drug in comparison to placebo or to an active comparator was described. The studies revealed the effectiveness of paliperidone palmitate in the treatment of psychotic symptoms, mainly schizophrenia. The drug proved to be efficacious in both acute psychotic symptoms treatment and long-term treatment. Its efficacy in patients with schizophrenia was similar and sometimes even better than the efficacy of other long-acting drugs, such as risperidone or olanzapine. In the pharmacoeconomic studies, paliperidone proved to be cost-effective in comparison to risperidone or olanzapine. The review of the literature also underlined that paliperidone palmitate is well tolerated, compared with placebo. Frequency and severity of side-effects such as extrapyramidal symptoms, hyperprolactinemia and weight gain, was similar or less than those found in treatment with other atypical antipsychotics, including long-acting ones.

摘要

该研究的目的是总结非典型长效抗精神病药物棕榈酸帕利哌酮的疗效和耐受性。帕利哌酮是利培酮的9-羟基代谢产物,其受体谱略有不同,药代动力学谱显著不同。在简要回顾其药理特性后,描述了该药物与安慰剂或活性对照药相比的疗效。研究揭示了棕榈酸帕利哌酮在治疗精神病性症状(主要是精神分裂症)方面的有效性。该药物在急性精神病性症状治疗和长期治疗中均被证明有效。其在精神分裂症患者中的疗效与其他长效药物(如利培酮或奥氮平)相似,有时甚至更好。在药物经济学研究中,与利培酮或奥氮平相比,帕利哌酮被证明具有成本效益。文献综述还强调,与安慰剂相比,棕榈酸帕利哌酮耐受性良好。锥体外系症状、高催乳素血症和体重增加等副作用的发生率和严重程度与其他非典型抗精神病药物(包括长效药物)治疗中发现的相似或更低。

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