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JAMA Neurol:抗精神病药物会加大帕金森患者死亡风险

2016-03-23 Mechront 译 MedSci原创

近期发表在JAMA Neurology的研究称,对帕金森患者常用的抗精神病药可能会造成额外伤害。抗精神病药物潜在的不良影响包括:降低警觉性、更高的糖尿病和心脏病的风险、低血压,长期而言还会导致类似帕金森的运动障碍。研究表明,高达60%的帕金森患者有精神病,80%的患者有痴呆。而先前有研究表明,抗精神病药物会增加痴呆患者的死亡风险。FDA也指出了抗精神病药物对痴呆患者的风险。早在2011年,Dani

近期发表在JAMA Neurology的研究称,对帕金森患者常用的抗精神病药可能会造成额外伤害。

抗精神病药物潜在的不良影响包括:降低警觉性、更高的糖尿病和心脏病的风险、低血压,长期而言还会导致类似帕金森的运动障碍。

研究表明,高达60%的帕金森患者有精神病,80%的患者有痴呆。而先前有研究表明,抗精神病药物会增加痴呆患者的死亡风险。FDA也指出了抗精神病药物对痴呆患者的风险。

早在2011年,Daniel Weintraub博士和同事就发现,这些研究这些警告并没有得到实质性的实践,对帕金森患者的抗精神病药处方仍下降不明显。为了进一步调查,Weintraub博士和宾夕法尼亚大学佩雷尔曼医学院、密歇根大学医学院以及费城,安阿伯市退伍军人事务部(VA)医学中心的研究者对退伍军人事务部数据库中约15000名患者进行了分析。

研究者们想知道,使用抗精神病药物是否会增加帕金森患者的死亡风险,而不仅仅局限于伴发痴呆的帕金森患者。

在1999-2010年期间,有7877名使用了抗精神病药物的帕金森患者,按年龄、种族、性别、诊断年份和有无痴呆匹配没有使用过抗精神病药物的对照组。

研究数据显示,使用了抗精神病药物的帕金森患者,在开始用药后的180天内,死亡风险是未使用者的2.35倍!使用奎硫平的患者,风险为2.16倍;使用利培酮的患者,风险为2.46倍;使用奥氮平的患者,风险为2.79倍;使用氟哌啶醇的患者,风险为5.08倍。

整体上,一代抗精神病药物(如氟哌啶醇)会比新近开发的抗精神病药物(如利培酮和喹硫平)风险高出50%。

虽然当前对这一联系背后潜在的机制仍不明确,不过Weintraub博士呼吁,对帕金森患者开具抗精神病药物之前能认真考虑。他建议通过其他方法如治疗与精神相关的其他医疗问题、减少多巴胺替代治疗剂量等进行患者的管理。

他说:“只有当患者的精神病具有临床意义时,才应该使用抗精神病药物,并且在该类药物的使用过程中,要对患者进行再评估。”

原始出处:

Association of antipsychotic use with mortality risk in patients with Parkinson disease,
Daniel Weintraub, JAMA Neurology, doi:10.1001/jamaneurol.2016.0031, published online 21 March 2016.

Antipsychotic drugs may be harmful for people with Parkinson's.MNT.23 March 2016


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    2016-05-31 yinhl1978
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    2016-03-24 Lisa971

    药物都难免有其副作用~

    0

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