de Boer J N, Brand B A, Sommer I E C
Tijdschr Psychiatr. 2023;65(2):87-94.
It has long been thought that women with a schizophrenia spectrum disorder have a more favorable course than men. However, this is not the case, even though they become ill later in life and are less likely to have comorbid drug abuse. Guidelines for prescribing antipsychotics are based on research with mostly male participants, and by following these guidelines we are doing our female patients a disservice. Gender and sex differences lead to differences in preferences, pharmacokinetics and pharmacodynamics.
Providing an overview of antipsychotics for women with a schizophrenia spectrum disorder and discuss the consequences for practice.
A clinically oriented study of the literature.
Women reach higher plasma levels than men when they receive the same dose of antipsychotic drugs (except for lurasidone and quetiapine). The effect of antipsychotics is also greater in women, because estrogens increase the brain’s dopamine sensitivity. This leads to higher risks of side effects. Clinical guidelines differ for women at different stages of life because estrogens greatly contribute to the sex differences seen in the efficacy and tolerability of antipsychotics.
Clinicians should be aware that women should be treated differently with antipsychotics than men.
长期以来，人们一直认为患有精神分裂症谱系障碍的女性病情发展比男性更有利。然而，实际情况并非如此，尽管她们发病较晚且合并药物滥用的可能性较小。抗精神病药物的处方指南大多基于以男性参与者为主的研究，遵循这些指南对我们的女性患者是一种伤害。性别差异会导致在偏好、药代动力学和药效学方面的不同。
概述用于患有精神分裂症谱系障碍女性的抗精神病药物，并讨论对临床实践的影响。
一项以临床为导向的文献研究。
当接受相同剂量的抗精神病药物时，女性的血浆水平高于男性（除了鲁拉西酮和喹硫平）。抗精神病药物对女性的效果也更强，因为雌激素会增加大脑对多巴胺的敏感性。这导致副作用风险更高。由于雌激素在很大程度上导致了抗精神病药物疗效和耐受性方面的性别差异，所以针对不同生活阶段的女性，临床指南也有所不同。
临床医生应意识到，女性使用抗精神病药物的治疗方式应与男性不同。
