Department of Psychiatry and Neuroscience, Riverside School of Medicine, University of California, Riverside, CA, USA.
Acta Psychiatr Scand. 2021 Feb;143(2):172-180. doi: 10.1111/acps.13266. Epub 2020 Dec 26.
As most treatment guidelines for antipsychotics focus on clinical efficacy, we will instead focus on adverse effects and how to manage them. In this review, we aim to provide an up-to-date clinical resource for providers who prescribe antipsychotics and have included here "what's new" and "what to do" for numerous antipsychotic-induced adverse effects.
A review was performed of relevant literature, studies, randomized clinical trials, and systematic reviews. This information was combined with the clinical experience of the authors to formulate a practical guide for treating adverse effects of antipsychotics with an emphasis on metabolic and movement disorder adverse effects and brief mention of some others (sedation and sexual dysfunction).
Antipsychotics are an integral part of psychiatric care and are often prescribed lifelong. When choosing an antipsychotic, special consideration must be given to adverse effects which have an undeniable impact on quality of life and can often be the deciding factor in patients' medication compliance. While patients may respond well to one specific medication, they may still experience adverse effects that lead them to discontinue it or switch to a more tolerable but less effective option. However, strategies do exist for managing and treating adverse effects, especially metabolic and movement adverse effects, allowing better personalization of antipsychotic choice.
由于大多数抗精神病药物治疗指南都侧重于临床疗效，因此我们将重点关注不良反应及其管理方法。在本次综述中，我们旨在为开具抗精神病药物的医务人员提供最新的临床资源，其中包括许多抗精神病药物引起的不良反应的“最新进展”和“应对措施”。
对相关文献、研究、随机临床试验和系统评价进行了综述。将这些信息与作者的临床经验相结合，制定了治疗抗精神病药物不良反应的实用指南，重点介绍了代谢和运动障碍不良反应，并简要提及了其他一些不良反应（镇静和性功能障碍）。
抗精神病药物是精神科治疗的重要组成部分，通常需要长期服用。在选择抗精神病药物时，必须特别考虑不良反应，这些不良反应对生活质量有不可否认的影响，往往是患者用药依从性的决定因素。虽然患者可能对特定药物反应良好，但他们仍可能会出现不良反应，导致他们停止使用该药物或转而使用更耐受但效果稍差的药物。然而，确实存在管理和治疗不良反应的策略，尤其是代谢和运动不良反应，这使得能够更好地针对患者个人情况选择抗精神病药物。
