Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada.
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Curr Neuropharmacol. 2019;17(9):852-860. doi: 10.2174/1570159X17666190228113348.
Metabolic abnormalities are serious health problems in individuals with schizophrenia. Paradoxically, studies have noted an association where individuals who gained body weight or who have increased their serum lipids demonstrated a better antipsychotic response. As serum lipids serve as more specific physiological markers than body weight, the objective of this study was to review studies that examined the association between changes in serum lipids and changes in symptoms during antipsychotic treatment in individuals with schizophrenia. A Medline® literature search was performed. Fourteen studies were included and analyzed. Evidence suggests that increases in serum lipids may be associated with decreases in symptoms during antipsychotic treatment. This inverse association may be independent of confounding variables, such as weight gain, and may be most evident during treatment with clozapine. Also, according to recent randomized controlled trials, lipid-lowering agents do not appear to worsen symptoms although this needs to be further investigated in clozapine-treated patients. Future studies should investigate the association in question in a larger population and identify underlying mechanisms.
代谢异常是精神分裂症患者的严重健康问题。矛盾的是，研究指出了一种关联，即体重增加或血清脂质增加的个体表现出更好的抗精神病反应。由于血清脂质比体重更能作为特定的生理标志物，因此本研究的目的是回顾检查精神分裂症个体在抗精神病治疗期间血清脂质变化与症状变化之间关联的研究。进行了 Medline®文献检索。纳入并分析了 14 项研究。有证据表明，血清脂质的增加可能与抗精神病治疗期间症状的减少有关。这种反比关系可能独立于体重增加等混杂变量，并且在氯氮平治疗期间可能最为明显。此外，根据最近的随机对照试验，降脂药物似乎不会加重症状，尽管这需要在氯氮平治疗的患者中进一步研究。未来的研究应该在更大的人群中调查这一关联，并确定潜在的机制。
