Coronado Belinda, Dunn Jacob, Veronin Michael A, Reinert Justin P
The University of Texas at Tyler, TX, USA.
Bon Secours Mercy Health St. Vincent Medical Center, Toledo, OH, USA.
J Pharm Technol. 2021 Aug;37(4):202-208. doi: 10.1177/87551225211004145. Epub 2021 Apr 19.
To determine the efficacy and safety of second-generation antipsychotics (SGAs) as adjunctive analgesics. A comprehensive literature review was conducted between August 2020 and January 2021 on PubMed, Scopus, and ProQuest Central. Keyword and Boolean phrase searches using the following terminology were conducted: "Quetiapine" OR "Risperidone" OR "Olanzapine" OR "Ziprasidone" AND "Analgesia" NOT "Psychosis" NOT "Psych." Articles that involved human adult patients who received any of the SGAs mentioned in the searching filter with an opioid were included. Articles that described pediatrics, pregnant women, patients who received any of these agents for treatment of psychosis and articles that were not in English, or readily translatable to English, were excluded. Three articles were selected for inclusion in this review, with 2 articles detailing reports with olanzapine and 1 article describing a randomized, controlled trial with extended-release quetiapine. Both olanzapine and quetiapine were able to decrease pain scores on the numeric rating scale, indicating a reduction pain experienced, and additionally reduced opioid craving behavior in patients. Depression scores and quality-of-life indicators improved with quetiapine, though those metrics were not studied with olanzapine. Select SGAs, specifically extended-release quetiapine and olanzapine, may serve as an appropriate adjunctive analgesic choice in select patients. Further research is required in a clinical setting to determine the exact role of this drug class in pain management.
确定第二代抗精神病药物（SGA）作为辅助镇痛药的疗效和安全性。2020年8月至2021年1月期间，在PubMed、Scopus和ProQuest Central上进行了全面的文献综述。使用以下术语进行关键词和布尔短语搜索：“喹硫平”或“利培酮”或“奥氮平”或“齐拉西酮”以及“镇痛”，不包括“精神病”和“精神科”。纳入涉及接受搜索过滤器中提及的任何一种SGA与阿片类药物联合治疗的成年患者的文章。排除描述儿科患者、孕妇、接受这些药物治疗精神病的患者的文章，以及非英文或难以翻译成英文的文章。选择了三篇文章纳入本综述，其中两篇详细报道了奥氮平，一篇描述了缓释喹硫平的随机对照试验。奥氮平和喹硫平均能够降低数字评分量表上的疼痛评分，表明疼痛减轻，此外还减少了患者对阿片类药物的渴望行为。喹硫平可改善抑郁评分和生活质量指标，不过奥氮平未对这些指标进行研究。特定的SGA，特别是缓释喹硫平和奥氮平，可能是特定患者合适的辅助镇痛选择。需要在临床环境中进行进一步研究，以确定这类药物在疼痛管理中的确切作用。
