Clinical Pharmacology Unit, Zealand University Hospital, Roskilde, Denmark.
Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark.
J Psychopharmacol. 2020 May;34(5):532-539. doi: 10.1177/0269881120903466. Epub 2020 Feb 12.
Understanding sex differences in adverse drug reactions to drugs for psychosis could potentially guide clinicians in optimal drug choices.
By applying a text-mining approach, this study aimed to investigate the relationship between drugs for psychosis and biological sex differences in frequencies and co-occurrences of potential adverse drug events (ADEs).
Electronic patient records of a psychiatric population (1427 men and 727 women) were text mined for potential ADEs. The relative risk of experiencing specific ADEs and co-occurrence of ADEs were calculated for each sex.
Findings included 55 potential ADEs with significantly different frequencies between the two sexes. Of these, 20 were more frequent in men, with relative risks of 1.10-7.64, and 35 were more frequent in women, with relative risks of 1.19-21.58. Frequent potential ADEs were psychiatric symptoms, including sexual dysfunction and disturbances in men, and gastrointestinal symptoms, suicidal and self-injurious behaviour and hyperprolactinemia-related events in women. Mention of different hyperprolactinemia-related ADEs often co-occurred in female patients but not in male patients.
Several known sex-related ADEs were identified, as well as some previously not reported. When considering the risk-benefit profile of drugs for psychosis, the patient's sex should be considered.
了解精神疾病药物不良反应中的性别差异,可能有助于临床医生做出最佳药物选择。
本研究采用文本挖掘方法,旨在探讨精神疾病药物与潜在药物不良反应(ADE)发生频率和共现的生物学性别差异之间的关系。
对精神科患者(男性 1427 例,女性 727 例)的电子病历进行文本挖掘,以寻找潜在的 ADE。计算了每种性别特定 ADE 的发生风险和 ADE 共现的相对风险。
共发现 55 种潜在 ADE,男女之间存在显著的频率差异。其中,20 种在男性中更为常见,相对风险为 1.10-7.64,35 种在女性中更为常见,相对风险为 1.19-21.58。常见的潜在 ADE 包括精神症状,如男性的性功能障碍和紊乱,以及女性的胃肠道症状、自杀和自残行为和与高催乳素血症相关的事件。女性患者常提到不同的与高催乳素血症相关的 ADE,但男性患者则不然。
本研究确定了一些已知的与性别相关的 ADE,以及一些以前未报告的 ADE。在考虑精神疾病药物的风险效益特征时,应考虑患者的性别。