Uniwersytet Medyczny we Wrocławiu, Wydział Lekarski Kształcenia Podyplomowego, Katedra Psychiatrii, Zakład Psychiatrii Konsultacyjnej i Badań Neurobiologicznych.
Uniwersytet Medyczny we Wrocławiu, Wydział Lekarski Kształcenia Podyplomowego, Katedra Psychiatrii, Klinika Psychiatrii.
Psychiatr Pol. 2020 Oct 31;54(5):977-989. doi: 10.12740/PP/OnlineFirst/109129.
Amisulpride is an antipsychotic available in Europe since 1990s, in Poland since 2000. Subsequent years brought to Polish market more second-generation compounds such as ziprasidone and aripiprazole. In 2018, the Agency for Health Technology Assessment and Tariff System issued positive recommendation for lurasidone in schizophrenia (Recommendation 30/2018) facilitating its entry to the market. Thanks to new molecules, therapeutic possibilities of medicines consequently rise, however, higher number of available substances of different properties brings also more dilemmas which one to pick. Since new publications of comparative drug trials, meta-analyses and systematic reviews are issued regularly, the authors present herein publications issued within last ten years focusing on amisulpride as opposed to other neuroleptics used in Poland. Although in many aspects it is equivalent to other atypical antipsychotics, it still has some advantages. Amisulpride seems to have better outcome than classic and atypical neuroleptics when it comes to depressive symptoms and predominant negative symptoms. It might also be superior to haloperidol in inducing symptomatic remission in first episode schizophrenia. Except for prolactin increase its side effects profile is favorable - it rarely leads to extrapyramidal symptoms (which are dose-dependent) and sedation. Therefore many patients accept treatment with amisulpride for its measurable clinical gains, such as improvement of positive symptoms and higher quality of life, compared to typical neuroleptics. Pharmacokinetics of amisulpride also encourage its wider use, especially when there is either a need for combined psychopharmacotherapy or comorbidity with general medical condition rises a need for somatic parallel treatment.
氨磺必利自 20 世纪 90 年代在欧洲上市以来，一直作为一种抗精神病药物在波兰使用。随后的几年里，更多的第二代化合物，如齐拉西酮和阿立哌唑，也进入了波兰市场。2018 年，卫生技术评估和价格系统局对氨磺必利治疗精神分裂症发布了积极推荐（推荐 30/2018），促进了其进入市场。由于新的分子，药物的治疗可能性随之提高，但更多不同特性的药物也带来了更多的选择难题。由于新的药物对照试验、荟萃分析和系统评价的出版物定期发布，作者在此介绍了过去十年内发表的关于氨磺必利与波兰其他使用的神经阻滞剂相比的出版物。尽管在许多方面它与其他非典型抗精神病药物相当，但它仍然具有一些优势。当涉及到抑郁症状和主要的阴性症状时，氨磺必利似乎比经典和非典型神经阻滞剂的疗效更好。它在诱导首发精神分裂症的症状缓解方面也可能优于氟哌啶醇。除了催乳素增加外，其副作用谱是有利的——它很少导致锥体外系症状（这是剂量依赖性的）和镇静。因此，许多患者接受氨磺必利治疗，因为与典型神经阻滞剂相比，它能带来可衡量的临床获益，如改善阳性症状和提高生活质量。氨磺必利的药代动力学也鼓励其更广泛的使用，特别是当需要联合精神药理学治疗时，或者当合并一般医疗状况导致需要躯体平行治疗时。
