Hyperlipidemia following treatment with antipsychotic medications
Hyperlipidemia following treatment with antipsychotic medications
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DOI：
10.1176/appi.ajp.163.10.1821
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发表时间：
2006-10-01
影响因子：
17.7
通讯作者：
L'Italien, Gilbert J.
中科院分区：
文献类型：
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作者：
Olfson, Mark;Marcus, Steven C.;L'Italien, Gilbert J.
目的：本研究试图估计与抗精神病药物治疗后发展为高脂血症的相对风险，没有抗精神病药物treatment.Method：匹配的病例对照分析进行了药房和索赔数据从加州医疗补助（Medi-Cal）。如果患者接受了医学疾病治疗或处方了已知会增加高脂血症风险的药物，则将其排除。病例年龄18 - 64岁，患有精神分裂症、重性抑郁症、双相情感障碍或其他情感性精神病和高脂血症。根据年龄、性别、种族和精神病诊断，将病例与最多6名对照受试者相匹配。两组在首次出现高脂血症（病例）或账单记录中匹配的索引日期（对照）前60天内，未开具抗精神病药物处方，或开具两种或多种一种且仅一种抗精神病药物处方。条件Logistic回归被用来获得优势比和95%的置信区间（95%CI）的每种抗精神病药物的关系，没有抗精神病药物。结果：共13,133例高脂血症事件匹配到72,140对照组。与不使用抗精神病药物相比，（比值比：1.82，95% CI：1.61-2.05），利培酮（比值比：1.53，95% CI：1.43-1.64），奎替尼（比值比：1.52，95% CI：1.40-1.65），奥氮平（比值比：1.56，95% CI：1.47-1.67），齐拉西酮（比值比：1.40，95% CI：1.19-1.65）和第一代抗精神病药（比值比：1.26，95% CI：1.14-1.39），但不是阿立哌唑（比值比：1.19，95%CI：0.94-1.52）与高脂血症发病风险显著增加相关。这些发现表明，最常用的抗精神病药物增加了精神分裂症或情绪障碍患者发生高脂血症的风险。
Objective: This study attempted to estimate the relative risk of developing hyperlipidemia after treatment with antipsychotics in relation to no antipsychotic treatment.Method: A matched case-control analysis was performed with pharmacy and claims data from California Medicaid (Medi-Cal). Patients were excluded if they were treated for medical disorders or prescribed medications known to increase their risk of hyperlipidemia. Cases were ages 18 to 64 years with schizophrenia, major depression, bipolar disorder, or other affective psychoses and incident hyperlipidemia. Cases were matched to up to six control subjects by age, sex, race, and psychiatric diagnosis. Both groups were prescribed either no antipsychotic medication or had two or more prescriptions for one and only one antipsychotic medication during the 60 days prior to the first indication of hyperlipidemia (cases) or matched index date ( controls) in the billing record. Conditional logistic regressions were used to derive odds ratios and 95% confidence intervals (95% CIs) of each antipsychotic medication in relation to no antipsychotic medication.Results: A total of 13,133 incident cases of hyperlipidemia were matched to 72,140 control subjects. As compared with no antipsychotic medication, treatment with clozapine (odds ratio: 1.82, 95% CI: 1.61-2.05), risperidone (odds ratio: 1.53, 95% CI: 1.43-1.64), quetiapine ( odds ratio: 1.52, 95% CI: 1.40-1.65), olanzapine (odds ratio: 1.56, 95% CI: 1.47-1.67), ziprasidone (odds ratio: 1.40, 95% CI: 1.19-1.65), and first-generation antipsychotics (odds ratio: 1.26, 95% CI: 1.14-1.39), but not aripiprazole (odds ratio: 1.19, 95% CI: 0.94-1.52) was associated with a significant increase in risk of incident hyperlipidemia.Conclusions: These findings suggest that most commonly prescribed antipsychotic medications increase the risk of developing hyperlipidemia in patients with schizophrenia or mood disorders.