Department of Psychiatry and Psychotherapy, TUM School of Medicine and Health, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany.
Section of Psychology, Department of Educational Sciences, University of Catania, Via Teatro Greco 84, 95124, Catania, Italy.
Clin Drug Investig. 2024 Sep;44(9):715-727. doi: 10.1007/s40261-024-01391-x. Epub 2024 Sep 20.
Patients undergoing antipsychotic treatment for psychiatric disorders may experience challenges in functioning, either stemming from the severity of the illness or from the tolerability issues of prescribed medications.
The aims of this cross-sectional study are to investigate the impact of adverse effects of antipsychotic drugs on patients' daily life functioning, comparing oral and long-acting injectable (LAI) antipsychotics, and further dividing antipsychotics by receptor-binding profiles based on recently defined data-driven taxonomy.
This study involved patients with schizophrenia and bipolar spectrum disorders taking oral or LAI antipsychotics. Disability and functioning levels were assessed using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS), and the adverse effects of medications were evaluated using the Udvalg for Kliniske Undersogelser (UKU) Side Effect Rating Scale and its subscales.
The total sample consisted of 126 participants with a diagnosis of schizophrenia-spectrum or bipolar disorder, and included 54 males and 72 females ranging from 18 to 78 years of age (mean 45.1, standard deviation 14); 78 patients were taking oral antipsychotics and 48 were taking LAI antipsychotics, with subcategories of muscarinic (31), adrenergic/low dopamine (25), serotonergic/dopaminergic (23), dopaminergic (1), LAI muscarinic (15), LAI adrenergic (6), and LAI serotonergic/dopaminergic (25). The UKU total score for adverse effects showed significant correlations with WHODAS total score (ρ = 0.475; p < 0.001). Compared with oral antipsychotics, LAIs showed significantly lower scores in psychological (p = 0.014), autonomic (p = 0.008), other (p = 0.004), and sexual adverse effects (p = 0.008), as well as the UKU total score (p = 0.002). The Kruskal-Wallis test showed a significant difference in adverse effects between LAI and oral muscarinic subgroups, with LAIs having lower scores compared with antipsychotics binding to muscarinic receptors (p = 0.043).
These findings indicate clinically relevant differences in adverse effects among formulations, warranting further investigation for future observational studies.
接受抗精神病药物治疗的精神障碍患者可能会在功能方面遇到挑战，这些挑战可能源于疾病的严重程度，也可能源于所开药物的耐受性问题。
本横断面研究旨在调查抗精神病药物的不良反应对患者日常生活功能的影响，比较口服和长效注射（LAI）抗精神病药，并根据最近定义的数据驱动分类法，根据受体结合谱进一步对抗精神病药进行分类。
本研究纳入了服用口服或 LAI 抗精神病药的精神分裂症和双相谱系障碍患者。使用世界卫生组织残疾评估表 2.0（WHODAS）评估残疾和功能水平，使用 Udvalg for Kliniske Undersogelser（UKU）副作用评定量表及其子量表评估药物的不良反应。
总样本包括 126 名精神分裂症谱系或双相障碍患者，其中男性 54 名，女性 72 名，年龄 18 至 78 岁（平均 45.1，标准差 14）；78 名患者服用口服抗精神病药，48 名患者服用 LAI 抗精神病药，亚类包括毒蕈碱（31）、肾上腺素能/低多巴胺（25）、5-羟色胺能/多巴胺能（23）、多巴胺能（1）、LAI 毒蕈碱（15）、LAI 肾上腺素能（6）和 LAI 5-羟色胺能/多巴胺能（25）。不良反应的 UKU 总分与 WHODAS 总分呈显著相关（ρ=0.475;p<0.001）。与口服抗精神病药相比，LAI 在心理（p=0.014）、自主（p=0.008）、其他（p=0.004）和性不良反应（p=0.008）以及 UKU 总分（p=0.002）方面的评分显著较低。Kruskal-Wallis 检验显示 LAI 和口服毒蕈碱亚组之间不良反应存在显著差异，LAI 的评分低于与毒蕈碱受体结合的抗精神病药（p=0.043）。
这些发现表明不同制剂之间的不良反应存在临床相关差异，需要进一步进行未来的观察性研究。
