Side effect burden of antipsychotic drugs in real life - Impact of gender and polypharmacy
Side effect burden of antipsychotic drugs in real life - Impact of gender and polypharmacy
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DOI：
10.1016/j.pnpbp.2017.11.004
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发表时间：
2018-03-02
影响因子：
5.6
通讯作者：
Jonsson, Erik G.
中科院分区：
文献类型：
--
作者：
Iversen, Trude Seselie Jahr;Steen, Nils Eiel;Jonsson, Erik G.
背景：抗精神病药物相关的副作用是众所周知的，并且是一个重大的治疗挑战。尽管如此，很少有大型研究调查现实生活中抗精神病药物的总体副作用负担。目的：在大的自然样本中描述抗精神病药物副作用的发生和感知负担，考虑到多药联用和患者特征。方法：在评估临床和药理学数据的基础上，使用Udvalg for Kliniske Undersogelser(UKU)副作用评定量表对1087例精神病患者进行副作用评估。对可能的混杂因素进行了统计分析。结果：抗精神病药物的使用与神经性症状、镇静和体重增加显著相关，75%的抗精神病药物使用者报告了副作用。在使用几种抗精神病药物(p=0.002)的患者中，观察到更多的副作用，随着总剂量的增加(p=0.021)，以及抗精神病药物与其他精神药物的联合使用。患者和研究人员对副作用负担的评估不同，特别是与严重程度、性别和抗精神病药物剂量有关。表示副作用负担严重的女性是女性的两倍(p=0.004)。结论：精神病患者与使用抗精神病药物有关的症状发生率较高，多药史和女性似乎是报告严重副作用负担的危险因素。由于横断面设计，因果关系的评估是试探性的，这些发现应该在前瞻性研究中进一步调查。
Background: Antipsychotic-associated side effects are well known and represent a significant treatment challenge. Still, few large studies have investigated the overall side effect burden of antipsychotics in real-life settings.Objective: To describe the occurrence of side effects and perceived burden of antipsychotics in a large naturalistic sample, taking polypharmacy and patient characteristics into account.Method: Patients (n = 1087) with psychotic disorders were assessed for side effects using the Udvalg for Kliniske Undersogelser (UKU) side effect rating scale in addition to assessment of clinical and pharmacological data. Statistical analyses were performed controlling for possible confounding factors.Results: Use of antipsychotics showed significant associations to neurologic and sexual symptoms, sedation and weight gain, and > 75% of antipsychotics-users reported side effects. More side effects were observed in patients using several antipsychotics (p = 0.002), with increasing total dose (p = 0.021) and with antipsychotics in combinations with other psychotropic drugs. Patients and investigators evaluated the side effect burden differently, particularly related to severity, gender and antipsychotics dose. Twice as many females described side effect burden as severe (p = 0.004).Conclusion: Patients with psychotic disorders have a high occurrence of symptoms associated with use of antipsychotics, and polypharmacy and female gender are seemingly risk factors for reporting a severe side effect burden. Due to the cross-sectional design evaluation of causality is tentative, and these findings should be further investigated in prospective studies.