Cockburn N, Pradhan A, Taing M W, Kisely S, Ford P J
The University of Queensland, School of Dentistry, UQ Oral Health Centre, Herston, Brisbane 4006 QLD, Australia.
The University of Queensland, School of Dentistry, UQ Oral Health Centre, Herston, Brisbane 4006 QLD, Australia.
J Affect Disord. 2017 Dec 1;223:184-193. doi: 10.1016/j.jad.2017.07.037. Epub 2017 Jul 23.
Many psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects.
The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions. For each medication, the generic name, class, and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (eMIMs) and UpToDate databases. Meyler's Side Effect of Drugs Encyclopaedia was used to identify additional oral adverse reactions to these medications.
Fifty-seven drugs were identified: 23 antidepressants, 22 antipsychotics or mood stabilisers, and 12 anxiolytic or sedative medications. Xerostomia (91%) the most commonly reported side effect among all classes of medications of the 28 identified symptoms. Other commonly reported adverse effects included dysguesia (65%) for antidepressants, and tardive dyskinesia (94%) or increased salivation (78%) for antipsychotic medications.
While xerostomia has often been reported as a common adverse effect of psychotropic drugs, this review has identified additional side effects including dysguesia from antidepressants and tardive dyskinesia and increased salivation from antipsychotics. Clinicians should consider oral consequences of psychotropic medication in addition to other side-effects when prescribing. For antidepressants, this would mean choosing duloxetine, agomelatine and any of the serotonin re-uptake inhibitors except sertraline. In the case of antipsychotics and mood stabilisers, atypical agents have less oral side effects than older alternatives.
许多精神药物会影响口腔健康。本综述确定了澳大利亚推荐用于治疗常见精神疾病的抗抑郁药、抗精神病药、抗惊厥药、抗焦虑药和镇静药的口腔副作用，并提供了管理这些副作用的建议。
检索澳大利亚治疗指南和澳大利亚药品手册中用于治疗常见精神健康状况的药物。对于每种药物，从在线医学专业月度索引（eMIMs）和UpToDate数据库中提取通用名、类别和药品公司报告的副作用。使用《梅耶尔药物副作用百科全书》来确定这些药物的其他口腔不良反应。
共识别出57种药物：23种抗抑郁药、22种抗精神病药或情绪稳定剂以及12种抗焦虑或镇静药物。在确定的28种症状中，口干（91%）是所有药物类别中最常报告的副作用。其他常见的不良反应包括抗抑郁药引起的味觉障碍（65%），以及抗精神病药物引起的迟发性运动障碍（94%）或流涎增加（78%）。
虽然口干常被报告为精神药物的常见不良反应，但本综述确定了其他副作用，包括抗抑郁药引起的味觉障碍、迟发性运动障碍以及抗精神病药引起的流涎增加。临床医生在开处方时，除了考虑其他副作用外，还应考虑精神药物对口腔的影响。对于抗抑郁药，这意味着选择度洛西汀、阿戈美拉汀以及除舍曲林之外的任何一种5-羟色胺再摄取抑制剂。对于抗精神病药和情绪稳定剂，非典型药物的口腔副作用比旧的替代药物少。
