Li Yanmei, Su Ruibing, Xu Shuqin, Huang Qingjun, Xu Haiyun
The Mental Health Center, Shantou University Medical College, Shantou, Guangdong Province, People's Republic of China.
Department of Anatomy, Shantou University Medical College, Shantou, Guangdong Province, People's Republic of China.
Neuropsychiatr Dis Treat. 2017 Sep 27;13:2477-2487. doi: 10.2147/NDT.S145069. eCollection 2017.
Clozapine is an atypical antipsychotic with therapeutic efficacy in treatment-resistant schizophrenia patients and low incidence of extrapyramidal side effects. However, the use of clozapine has been limited by its adverse effects on metabolism. Artesunate is a semisynthetic derivative of artemisinin and was shown to decrease the plasma cholesterol and triglyceride in rabbits and rats in recent studies. The aim of this study was to examine possible effects of artesunate on the clozapine-induced metabolic alterations in rats given saline, clozapine, artesunate, or clozapine plus artesunate for 6 weeks. The clozapine group showed significantly high plasma levels of triglyceride, hepatic steatosis, and fibrosis along with high levels of C-reactive protein, alanine aminotransferase, and aspartate aminotransferase compared to the saline group. But the treatment had no effect on weight gain and caused no hyperglycemia, hyperinsulinemia, and behavioral changes in the rats. More significantly, these clozapine-induced changes were not seen in rats coadministered with clozapine plus artesunate. These results added evidence supporting psychiatrists to try add-on treatment of artesunate in schizophrenia patients to ameliorate clozapine-induced adverse metabolic effects.
氯氮平是一种非典型抗精神病药物，对难治性精神分裂症患者具有治疗效果，且锥体外系副作用发生率较低。然而，氯氮平的使用因其对代谢的不良影响而受到限制。青蒿琥酯是青蒿素的半合成衍生物，最近的研究表明，它能降低兔和大鼠的血浆胆固醇和甘油三酯水平。本研究的目的是检测青蒿琥酯对给予生理盐水、氯氮平、青蒿琥酯或氯氮平加青蒿琥酯6周的大鼠中氯氮平诱导的代谢改变的可能影响。与生理盐水组相比，氯氮平组的甘油三酯血浆水平显著升高，出现肝脂肪变性和纤维化，同时C反应蛋白、丙氨酸转氨酶和天冬氨酸转氨酶水平也升高。但该治疗对大鼠体重增加没有影响，也未导致高血糖、高胰岛素血症和行为改变。更显著的是，在联合使用氯氮平和青蒿琥酯的大鼠中未观察到这些氯氮平诱导的变化。这些结果进一步证明，支持精神科医生尝试在精神分裂症患者中加用青蒿琥酯治疗，以改善氯氮平诱导的不良代谢效应。
