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长效抗精神病药物治疗:关注精神分裂症女性患者

Long-acting antipsychotic treatments: focus on women with schizophrenia.

作者信息

Brissos Sofia, Balanzá-Martínez Vicent

机构信息

Centro Hospitalar Psiquiátrico de Lisboa, Av. Brasil 53, Lisbon 1700, Portugal.

Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, CIBERSAM, INCLIVA, University of Valencia, Valencia, Spain.

出版信息

Ther Adv Psychopharmacol. 2024 Jul 31;14:20451253241263715. doi: 10.1177/20451253241263715. eCollection 2024.

Abstract

Effective management of schizophrenia (SZ) requires long-term treatment with antipsychotics (APs) to prevent clinical relapse, attain remission and improve patients' personal and social functioning, and quality of life. Although APs remain the cornerstone treatment for patients with SZ, despite their potential benefits, long-acting injectable APs (LAI-APs) remain underused, most notably in women with SZ. The efficacy and tolerability of APs differ significantly between men and women, and some of these differences are more noticeable depending on the patient's age and the stage of the disorder. Although sex differences may influence treatment outcomes in SZ, their pertinence has been insufficiently addressed, especially regarding the use of LAI-APs. Some biological and social experiences, such as pregnancy, lactation, contraception and menopause, are specific to women, but these remain under-researched issues. Implications of this disorder in parenting are also of special pertinence regarding women; therefore, taking sex differences into account when treating SZ patients is now recommended, and improving personalized approaches has been proposed as a priority in the management of psychosis. In this narrative, critical review, we address some aspects specific to sex and their implications for the clinical management of women with SZ, with a special focus on the potential role of LAI-AP treatments.

摘要

精神分裂症(SZ)的有效管理需要使用抗精神病药物(APs)进行长期治疗,以预防临床复发、实现缓解并改善患者的个人和社会功能以及生活质量。尽管APs仍然是SZ患者的基石治疗方法,但尽管它们有潜在益处,长效注射用APs(LAI-APs)的使用仍然不足,在患有SZ的女性中尤为明显。APs的疗效和耐受性在男性和女性之间存在显著差异,其中一些差异根据患者的年龄和疾病阶段更为明显。尽管性别差异可能会影响SZ的治疗结果,但其相关性尚未得到充分探讨,特别是关于LAI-APs的使用。一些生物学和社会经历,如怀孕、哺乳、避孕和更年期,是女性特有的,但这些仍然是研究不足的问题。这种疾病对育儿的影响对于女性也具有特殊的相关性;因此,现在建议在治疗SZ患者时考虑性别差异,并提出改进个性化方法是精神病管理的优先事项。在这篇叙述性的批判性综述中,我们阐述了一些特定于性别的方面及其对SZ女性临床管理的影响,特别关注LAI-AP治疗的潜在作用。

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