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喹硫平滥用 14 年后:我们现在在哪里?系统评价。

Quetiapine Abuse Fourteen Years Later: Where Are We Now? A Systematic Review.

机构信息

NESMOS Department (Neurosciences, Mental Health and Sensory Organs), Sapienza University - Rome, School of Medicine and Psychology; Sant'Andrea Hospital, Rome, Italy.

School of psychology - G. Marconi, Telematic University, Rome, Italy.

出版信息

Subst Use Misuse. 2020;55(2):304-313. doi: 10.1080/10826084.2019.1668013. Epub 2019 Oct 1.

Abstract

Quetiapine, an atypical antipsychotic endowed with weak dopamine antagonist, potent 5-HT-blocking, partial 5-HT-agonist, anti-H histamine, adrenolytic, and sigma receptor agonist activities, since an original 2004 report is increasingly misused. Although some of its pharmacodynamics might explain some motives for voluptuary use, most of its actions are directed at setting-off those motives. Hence, it is possible that its popularity in special populations is due to the fact that the unpleasant or unwanted effects of addiction substances are somehow soothed by quetiapine. Currently, quetiapine is tested in substance use disorders, showing some promise, but it is likely to be misused in certain contexts. To review the evidence for the use of quetiapine as addiction substance and investigate the characteristics of populations involved in such addiction. A systematic review of literature on various databases retrieved on September 7, 2018 87 records to comment. We reviewed the evidence for quetiapine's addictive potential in the light of its pharmacodynamics properties and presented two cases of recreational quetiapine use, by a 35-year old male patient with past addictive behavior and by a 50-year-old woman with major depressive disorder and conversion disorder. We found quetiapine to be abused mainly by addict populations and people with law involvement. There is no reason to include quetiapine among regulated substances, but monitoring of its use in selected populations is warranted. Psychiatrists and physicians working in the penitentiary system should be aware of the addictive potential of quetiapine and adopt measures restricting its use.

摘要

喹硫平,一种具有弱多巴胺拮抗作用、强效 5-HT 阻断作用、部分 5-HT 激动作用、抗组胺 H1 作用、肾上腺素能阻断作用和 sigma 受体激动作用的非典型抗精神病药,自 2004 年的原始报告以来,其使用越来越多。尽管其一些药效学可能解释了一些滥用的动机,但它的大多数作用都是为了引发这些动机。因此,它在特殊人群中的流行可能是因为喹硫平某种程度上缓解了成瘾物质的不愉快或不良影响。目前,喹硫平正在物质使用障碍中进行测试,显示出一些希望,但它可能会在某些情况下被滥用。 本文旨在综述喹硫平作为成瘾物质的使用证据,并探讨涉及此类成瘾的人群特征。 我们对 2018 年 9 月 7 日检索到的各种数据库中的文献进行了系统综述,共检索到 87 篇记录进行评论。 我们根据其药效学特性综述了喹硫平的成瘾潜力证据,并介绍了两例娱乐性喹硫平使用的病例,分别是一名有过去成瘾行为的 35 岁男性患者和一名患有重度抑郁症和转换障碍的 50 岁女性。我们发现喹硫平主要被成瘾人群和有法律问题的人群滥用。 没有理由将喹硫平列入管制物质,但有必要对其在选定人群中的使用进行监测。在监狱系统中工作的精神科医生和医生应该意识到喹硫平的成瘾潜力,并采取措施限制其使用。

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