Antipsychotic Use and Common Adverse Effects among Patients with Mental Disorders
Gomez-Llusa Rodriguez, Susana |
Recenzentas / Reviewer |
Pavadinimas: Antipsichozinių vaistų skyrimas ir dažniausis nepageidaujami poveikia pacientams, sergantiems psichikos sutrikimais
Tikslas: Apžvelgti ir pristatyti pastarųjų dešimties metų skirtumus ir pasiekimus, susijusius su antipsichotikų vartojimu ir jų bendru nepageidaujamu poveikiu psichikos sutrikimų turintiems pacientams.
Metodika: Atlikta tradicinė literatūros apžvalga pagal PRISMA metodiką, naudojant „PubMed“ ir „Medscape“ šaltinius. Taikant pašalinimo ir įtraukimo kriterijus, į šią literatūros apžvalgą galėjo būti įtraukti 47 straipsniai.
Išvados:
- Antipsichoziniai vaistai, ypač atipiniai antipsichotikai, tokie kaip kvetiapinas ir olanzapinas, šiuo metu naudojami šizofrenijai ir kitiems psichoziniams sutrikimams gydyti. 2.Tipiniai ir atipiniai antipsichoziniai vaistai yra panašiai veiksmingi, tačiau skiriasi jų veikimo mechanizmas ir nepageidaujamas poveikis.
- Tipiniai antipsichoziniai vaistai dažniausiai sukelia ekstrapiramidinį nepageidaujamą poveikį, o atipiniai antipsichoziniai vaistai - medžiagų apykaitos sutrikimus.
- Nepageidaujamas poveikis paprastai malšinamas mažinant antipsichotinio vaisto dozę arba keičiant jį kitu antipsichotiniu vaistu, pasižyminčiu geresniu saugumo profiliu.
- Nauji tyrimai, tokie kaip lumateperonas ar naringinas, atrodo daug žadančios naujos galimybės, kaip būsimi nauji gydymo būdai, siekiant sumažinti nepageidaujamą antipsichozinių vaistų poveikį.
Aim: To review and present the differences and advances in the past ten years over the topic of antipsychotic use and its common adverse effects in patients with mental disorders.
Objectives: 1. To review the most common antipsychotics used in the treatment of patients with mental disorders, its classes and indications. 2. To present the main adverse effects of the typical antipsychotics and their management. 3. To present the main adverse effects of the atypical antipsychotics and their management. 4. To compare the effects and adverse effects of the main classes of antipsychotics. 5. To describe new tactics in the management of the adverse effects of antipsychotics in the treatment of patients with mental disorders
Methodology: A traditional literature review was conducted using the PRISMA methodology and using “PubMed” and “Medscape” sources. When applying exclusion and inclusion criteria, 47 articles were eligible to be included in this literature review.
Results: APDs, especially atypical, are the drugs chosen nowadays to treat schizophrenia and other psychotic disorders. Typical and atypical APDs have similar efficacy but differ in their mechanism of action and adverse effects. Typical APDs present mainly with EPS, while atypical APDs present mostly with metabolic disturbances. Adverse effects are managed by reduction of APD dose or switching to an APD with a better safety profile. For this goal, new drugs such as lumateperone, naringin or pimavanserin are under investigation.
Conclusions:
- APDs are classified into typical and atypical, being the latter (quetiapine and olanzapine) the most used for the treatment of schizophrenia and schizoaffective disorders.
- The most common adverse effect of the typical APDs are EPS, mostly treated by lowering of the APD dose or by switching to an atypical APD.
- The most common adverse effects of the atypical APDs are: metabolic syndrome, treated by diet changes and exercise followed by medication (metformin, statins); and cardiac and sexual adverse effects, treated by discontinuation or reduction of APD dose.
- Both classes of APDs have similar efficacy but different adverse effect profiles, being aripiprazole the APD with the best safety profile on the market.
- New researches are looking into novel treatments to minimize the adverse effects caused by APD.