Yang Rui, Wan Jin-Ling, Pi Chen-Qi, Wang Tian-Hui, Zhu Xue-Quan, Zhou Shuang-Jiang
Beijing Anding Hospital, Capital Medical University, Beijing, China.
Zhangjiakou Shalingzi Hospital, Zhangjiakou Mental Health Center, Zhangjiakou, Hebei, China.
Front Psychiatry. 2024 Jul 15;15:1421370. doi: 10.3389/fpsyt.2024.1421370. eCollection 2024.
Examine the alterations in antipsychotic concentrations following coronavirus disease-2019 (COVID-19) infection among hospitalized patients with mental disorders and conduct an analysis of the factors influencing these changes.
Data were collected from inpatients at Beijing Huilongguan Hospital between December 12, 2022, and January 11, 2023, pre- and post-COVID-19. Based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, 329 inpatients with mental disorders were included (3 with incomplete data excluded). Primary outcomes assessed changes in antipsychotic concentrations pre- and post-COVID-19, while secondary outcomes examined factors linked to concentration increases and antipsychotic dose adjustments.
Clozapine (P < 0.001), aripiprazole (P < 0.001), quetiapine (P = 0.005), olanzapine (P < 0.001), risperidone (P < 0.001), and paliperidone (P < 0.001) concentrations increased post-COVID-19 in patients with mental disorders. Notably, clozapine concentration surpassing pre-infection levels was highest. Clozapine users were more likely to adjust their dose (50.4%) compared to olanzapine (17.5%) and other antipsychotics. Moreover, traditional Chinese patent medicines and antibiotics during COVID-19 infection were associated with antipsychotic reduction or withdrawal (OR = 2.06, P = 0.0247; OR = 7.53, P = 0.0024, respectively).
Antipsychotic concentrations in hospitalized patients with mental disorders increased after COVID-19 infection, that may be related not only to COVID-19, but also to the use of Chinese patent medicines during infection. The pre-infection concentration and types of antipsychotics, patient's gender, and combination of traditional Chinese medicine or antibiotics, were factors found to correlate with increased drug concentrations and necessitate dose adjustments.
研究精神障碍住院患者感染新型冠状病毒肺炎（COVID-19）后抗精神病药物浓度的变化，并分析影响这些变化的因素。
收集2022年12月12日至2023年1月11日期间北京回龙观医院COVID-19感染前后住院患者的数据。根据《精神障碍诊断与统计手册》第五版，纳入329例精神障碍住院患者（排除3例数据不完整者）。主要结局评估COVID-19感染前后抗精神病药物浓度的变化，次要结局研究与浓度升高及抗精神病药物剂量调整相关的因素。
精神障碍患者感染COVID-19后，氯氮平（P<0.001）、阿立哌唑（P<0.001）、喹硫平（P=0.005）、奥氮平（P<0.001）、利培酮（P<0.001）和帕利哌酮（P<0.001）浓度升高。值得注意的是，氯氮平浓度超过感染前水平的情况最为常见。与奥氮平（17.5%）和其他抗精神病药物相比，氯氮平使用者更有可能调整剂量（50.4%）。此外，COVID-19感染期间使用中成药和抗生素与抗精神病药物减量或停药有关（分别为OR=2.06，P=0.0247；OR=7.53，P=0.0024）。
精神障碍住院患者感染COVID-19后抗精神病药物浓度升高，这可能不仅与COVID-19有关，还与感染期间使用中成药有关。感染前抗精神病药物的浓度和类型、患者性别以及中药或抗生素的联合使用，是发现与药物浓度升高及需要调整剂量相关的因素。
