Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, team Pharmacoepidemiology, UMR 1219, Bordeaux, F-33000, France.
CHU de Bordeaux, Pôle de Santé Publique, Service de Pharmacologie Médicale, Bordeaux, F-33000, France.
Br J Clin Pharmacol. 2021 Oct;87(10):3971-3977. doi: 10.1111/bcp.14818. Epub 2021 Mar 27.
Antipsychotics and lithium are widely used in psychiatry, particularly in schizophrenia and bipolar disorders. Recently, some cases of somnambulism or sleep-related eating disorder (SRED) have been reported in patients treated with these drugs. This study investigated the risk of reporting somnambulism or SRED associated with the use of antipsychotics and lithium.
The World Health Organization pharmacovigilance database (VigiBase), comprising >18 million adverse events, was queried. All somnambulism or SRED reports related to antipsychotics or lithium were identified. The association between antipsychotics or lithium and somnambulism or SRED was computed using the proportional reporting ratio (PRR) and information component.
Among the 5784 cases reporting somnambulism or SRED, 508 suspected at least 1 antipsychotic or lithium. Most patients were aged 18-64 years (62.0%), and 37.0% were men. In most cases (77.6%), antipsychotic or lithium were the only drug class involved, and 53.3% of cases suspected quetiapine. Somnambulism was reported in 88.6% of cases and SRED in 18.1%. A significant association was found for second-generation antipsychotics (PRR 3.44, 95% confidence interval 3.13) and lithium (PRR 2.03, [1.22; 3.37]), but not for first-generation antipsychotics (PRR 0.99, [0.68; 1.44]).
We found a significant signal of somnambulism or SRED related to second-generation antipsychotics and lithium. While case reports mentioned mostly quetiapine and olanzapine, almost all second-generation antipsychotics were associated with somnambulism or SRED.
抗精神病药和锂在精神病学中被广泛应用，特别是在精神分裂症和双相情感障碍的治疗中。最近，一些使用这些药物的患者出现了梦游或与睡眠相关的进食障碍（SRED）的病例报告。本研究旨在探讨抗精神病药和锂与梦游或 SRED 相关的风险。
我们查询了世界卫生组织药物警戒数据库（VigiBase），该数据库包含超过 1800 万例不良反应报告。我们确定了所有与抗精神病药或锂相关的梦游或 SRED 报告。使用比例报告比值（PRR）和信息成分来计算抗精神病药或锂与梦游或 SRED 之间的关联。
在 5784 例报告梦游或 SRED 的病例中，有 508 例疑似至少使用了 1 种抗精神病药或锂。大多数患者年龄在 18-64 岁之间（62.0%），37.0%为男性。在大多数情况下（77.6%），涉及的药物类别仅为抗精神病药或锂，53.3%的病例疑似为喹硫平。88.6%的病例报告了梦游，18.1%的病例报告了 SRED。第二代抗精神病药（PRR 3.44，95%置信区间 3.13）和锂（PRR 2.03，[1.22; 3.37]）与梦游或 SRED 显著相关，但第一代抗精神病药（PRR 0.99，[0.68; 1.44]）与梦游或 SRED 不相关。
我们发现梦游或 SRED 与第二代抗精神病药和锂之间存在显著关联。虽然病例报告大多提到了喹硫平和奥氮平，但几乎所有的第二代抗精神病药都与梦游或 SRED 相关。
