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口服与长效注射用抗精神病药物治疗的精神分裂症患者中苯二氮䓬类药物与心境稳定剂的应用——一项观察性研究

Benzodiazepines and Mood Stabilizers in Schizophrenia Patients Treated with Oral versus Long-Acting Injectable Antipsychotics-An Observational Study.

作者信息

Miron Ana Aliana, Petric Paula Simina, Teodorescu Andreea, Ifteni Petru, Chele Gabriela, Szalontay Andreea Silvana

机构信息

Facultatea de Medicină, Universitatea Transilvania din Brașov, Bulevardul Eroilor nr. 29, 500036 Brașov, Romania.

Spitalul Clinic de Psihiatrie și Neurologie Brașov, Str. Prundului nr. 7-9, 500123 Brașov, Romania.

出版信息

Brain Sci. 2023 Jan 20;13(2):173. doi: 10.3390/brainsci13020173.

Abstract

Schizophrenia is a chronic, invalidating, and polymorphic disease, characterized by relapses and remission periods. The main treatment option in schizophrenia are antipsychotics, administered as an oral or as a long-acting injectable (LAI) formulation. Although international guidelines rarely recommend it, mood stabilizers (MS) and/or benzodiazepines (BZD) are frequently prescribed as adjunctive therapy in schizophrenia patients for various reasons. This is an observational, cross-sectional study including stabilized schizophrenia patients. A total of 315 patients were enrolled. Of these, 77 patients (24.44%) were stabilized on LAIs and 238 (75.56%) patients on oral antipsychotics (OAP). Eighty-four patients (26.66%) had concomitant treatment with MS and 119 patients (37.77%) had concomitant benzodiazepine treatment. No statistical significance was observed in MS or BZD use between LAIs and OAPs. In total, 136 patients (43.17%) were stabilized on antipsychotic monotherapy. Our study shows that the long-term use of benzodiazepines and mood stabilizers remains elevated among stabilized schizophrenia patients, regardless of the antipsychotic formulation (oral or LAI). Patients receiving second-generation LAI antipsychotics (SGA-LAI) seem to be more likely to be stabilized on monotherapy compared to those receiving oral antipsychotics. Further randomized controlled trials are necessary in order to clarify the benefits of the current drug polypharmacy trends.

摘要

精神分裂症是一种慢性、致残且具有多态性的疾病,其特征为病情复发和缓解期。精神分裂症的主要治疗选择是抗精神病药物,以口服或长效注射(LAI)制剂的形式给药。尽管国际指南很少推荐,但出于各种原因,情绪稳定剂(MS)和/或苯二氮䓬类药物(BZD)在精神分裂症患者中常被用作辅助治疗。这是一项观察性横断面研究,纳入了病情稳定的精神分裂症患者。共招募了315名患者。其中,77名患者(24.44%)使用长效注射剂病情稳定,238名患者(75.56%)使用口服抗精神病药物(OAP)病情稳定。84名患者(26.66%)同时接受情绪稳定剂治疗,119名患者(37.77%)同时接受苯二氮䓬类药物治疗。在使用长效注射剂和口服抗精神病药物的患者之间,在使用情绪稳定剂或苯二氮䓬类药物方面未观察到统计学差异。总共有136名患者(43.17%)通过抗精神病药物单一疗法病情稳定。我们的研究表明,无论抗精神病药物制剂是口服还是长效注射,在病情稳定的精神分裂症患者中,苯二氮䓬类药物和情绪稳定剂的长期使用率仍然很高。与接受口服抗精神病药物的患者相比,接受第二代长效注射抗精神病药物(SGA-LAI)的患者似乎更有可能通过单一疗法病情稳定。有必要进行进一步的随机对照试验,以阐明当前药物联合使用趋势的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/298c/9953951/a1505f539c46/brainsci-13-00173-g001.jpg

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