Instytut Psychiatrii i Neurologii w Warszawie, III Klinika Psychiatryczna.
Uniwersytet Jagielloński Collegium Medicum, Katedra Psychiatrii, Zakład Zaburzeń Afektywnych.
Psychiatr Pol. 2021 Oct 31;55(5):967-987. doi: 10.12740/PP/140287.
D2/D3 dopamine receptor partial agonists (aripiprazole, brexpiprazole, cariprazine) are increasingly often used in the treatment of mental disorders due to a more favourable tolerability profile as compared to other antipsychotics. The article presents the position statement on the use of these drugs in the treatment of special populations: people with comorbid somatic diseases, people over 65 years of age, including those with dementia, children and adolescents, pregnant and breastfeeding women. The position statement was developed by the panel of experts appointedby the Executive Board of the Polish Psychiatric Association consisting of people experienced in the treatment of patients with mental disorders. The evaluation included the analysis of literature databases and information obtained from summaries of product characteristics, as well as reports and registers on the safety of the three evaluated drugs. D2/D3 dopamine receptor partial agonists can be used in the treatment of people who must be provided with the highest safety standards of the therapy. It results from their low risk of producing side effects, such as weight gain, metabolic disorders, akathisia, extrapyramidal symptoms, increased prolactin levels, prolongation of QTinterval in ECG, sedation and anticholinergic effects. Since dopamine receptor partial agonists are available for arelatively short time, there is less information on their use in pregnant women than for other antipsychotics.
D2/D3 多巴胺受体部分激动剂(阿立哌唑、布瑞哌唑、卡利拉嗪)由于与其他抗精神病药物相比具有更好的耐受性,因此越来越多地用于治疗精神障碍。本文介绍了这些药物在特殊人群治疗中的应用立场声明:患有合并躯体疾病的人群、65 岁以上人群,包括痴呆患者、儿童和青少年、孕妇和哺乳期妇女。该立场声明是由波兰精神病学协会执行委员会任命的专家小组制定的,成员包括在治疗精神障碍患者方面经验丰富的人员。评估包括对文献数据库的分析以及从产品特性摘要、药物安全性报告和登记处获得的信息。D2/D3 多巴胺受体部分激动剂可用于必须提供最高治疗安全性标准的人群。这是因为它们产生副作用的风险较低,例如体重增加、代谢紊乱、静坐不能、锥体外系症状、催乳素水平升高、心电图 QT 间期延长、镇静和抗胆碱能作用。由于多巴胺受体部分激动剂的应用时间相对较短,因此关于它们在孕妇中的应用信息比其他抗精神病药物少。