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精神药物治疗的代谢不良反应:一项系统综述。

Metabolic Adverse Effects of Psychotropic Drug Therapy: A Systematic Review.

作者信息

Sepúlveda-Lizcano Lizeth, Arenas-Villamizar Vivian Vanessa, Jaimes-Duarte Enna Beatriz, García-Pacheco Henry, Paredes Carlos Silva, Bermúdez Valmore, Rivera-Porras Diego

机构信息

Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Cúcuta 540001, Colombia.

Facultad de Salud, Universidad de Pamplona, Pamplona 543050, Colombia.

出版信息

Eur J Investig Health Psychol Educ. 2023 Aug 12;13(8):1505-1520. doi: 10.3390/ejihpe13080110.

Abstract

This review aimed to investigate the metabolic alterations associated with psychopharmacological treatment of neuropsychiatric disorders, which can significantly impact patients' physical health and overall quality of life. The study utilized the PRISMA methodology and included cross-sectional, retrospective studies, and randomized clinical trials from reputable databases like SCOPUS, CLARIVATE, SCIENCE DIRECT, and PUBMED. Out of the 64 selected studies, various psychotropic drug classes were analyzed, including antidepressants, anticonvulsants, and antipsychotics. Among the antidepressants, such as amitriptyline, Imipramine, and clomipramine, weight gain, constipation, and cardiovascular effects were the most commonly reported metabolic adverse effects. SSRI antidepressants like Fluoxetine, Sertraline, Citalopram, Escitalopram, and Paroxetine exhibited a high prevalence of gastrointestinal and cardiac alterations. Regarding anticonvulsants, valproic acid and Fosphenytoin were associated with adverse reactions such as weight gain and disturbances in appetite and sleep patterns. As for antipsychotics, drugs like Clozapine, Olanzapine, and Risperidone were linked to weight gain, diabetes, and deterioration of the lipid profile. The findings of this review emphasize the importance of continuous monitoring for adverse effects, particularly considering that the metabolic changes caused by psychopharmacological medications may vary depending on the age of the patients. Future research should focus on conducting field studies to further expand knowledge on the metabolic effects of other commonly prescribed psychotropic drugs. Overall, the study highlights the significance of understanding and managing metabolic alterations induced by psychopharmacological treatment to enhance patient care and well-being.

摘要

本综述旨在研究与神经精神疾病心理药物治疗相关的代谢改变,这些改变会对患者的身体健康和整体生活质量产生重大影响。该研究采用PRISMA方法,纳入了来自SCOPUS、CLARIVATE、SCIENCE DIRECT和PUBMED等知名数据库的横断面研究、回顾性研究和随机临床试验。在所选的64项研究中,分析了各种精神药物类别,包括抗抑郁药、抗惊厥药和抗精神病药。在抗抑郁药中,如阿米替林、丙咪嗪和氯米帕明,体重增加、便秘和心血管影响是最常报告的代谢不良反应。氟西汀、舍曲林、西酞普兰、艾司西酞普兰和帕罗西汀等选择性5-羟色胺再摄取抑制剂(SSRI)抗抑郁药胃肠道和心脏改变的发生率较高。关于抗惊厥药,丙戊酸和磷苯妥英与体重增加、食欲和睡眠模式紊乱等不良反应有关。至于抗精神病药,氯氮平、奥氮平和利培酮等药物与体重增加、糖尿病和脂质谱恶化有关。本综述的结果强调了持续监测不良反应的重要性,特别是考虑到心理药物治疗引起的代谢变化可能因患者年龄而异。未来的研究应侧重于开展实地研究,以进一步扩大对其他常用精神药物代谢影响的认识。总体而言,该研究强调了了解和管理心理药物治疗引起的代谢改变以提高患者护理和福祉的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc12/10453914/6179a9201817/ejihpe-13-00110-g001.jpg

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