JAMA Psychiatry:14余万SMI患者的观察性研究提示他汀或有抗精神病效果

2019-02-08 佚名 嘉音

1月9日,在线发表于《JAMA Psychiatry》杂志上的一项研究显示,他汀、L型钙拮抗剂(如维拉帕米)和双胍类药物(二甲双胍),这些用来治疗心血管病和糖尿病的药物,对双相情感障碍(BPD)、精神分裂症或非情感性精神病等严重精神疾病(SMI)的患者也有一定疗效。

1月9日,在线发表于《JAMA Psychiatry》杂志上的一项研究显示,他汀、L型钙拮抗剂(如维拉帕米)和双胍类药物(二甲双胍),这些用来治疗血管病和糖尿病的药物,对双相情感障碍(BPD)、精神分裂症或非情感性精神病等严重精神疾病(SMI)的患者也有一定疗效。

药物再利用具有潜在的成本效益与低风险,这在精神药物开发中是必要的。该研究纳入142691例SMI患者(76759例BPD,30954例精神分裂症,34978例非情感性精神病),通过对其进行个体队列研究,比较患者接触和不接触研究药物期间的精神病住院率和自残率,并对一些时变协变量进行了调整。目的是观察他汀、L型钙拮抗剂、双胍类药物是否与SMI个体减少精神病住院和自我伤害相关。 

研究人员发现,接受上述3种药物中任何药物治疗的SMI患者因精神病住院的风险明显降低,降幅从8%~27%不等。精神分裂症和BPD患者在接受上述三类药物治疗期间自残的几率降低,降幅最高达70%,非情感性精神病患者仅接受L型钙拮抗剂治疗时自残风险降低44%。

研究者认为L型钙拮抗剂有抗精神病效果容易解释;而二甲双胍,其抗精神病作用可能与改善认知和心境失调症状有关;他汀的抗精神病效果则可能与其抗炎作用以及促进中枢神经系统对抗精神病药的摄取与吸收有关。

研究者指出,精神病患者往往也属于血管病、高血压糖尿病高风险人群,临床医师要优化精神病患者的这些合并疾病的药物治疗,但并不建议在精神病患者中用这些心血管病和糖尿病治疗药物来替代现有的常规抗精神病药物。同时,据研究者透露,目前全球有一些评估上述心血管病或糖尿病药物治疗严重精神病的随机对照试验正在进行中,这些研究可能有助于阐明这些药物对中枢神经系统的作用。

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    2019-02-09 1e145228m78(暂无匿称)

    学习了,谢谢作者分享!

    0

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    2019-02-08 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1792139, encodeId=4d771e921396e, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Mon Apr 22 11:23:00 CST 2019, time=2019-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1499821, encodeId=7f16149982150, content=<a href='/topic/show?id=113c90584e6' target=_blank style='color:#2F92EE;'>#观察性研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90584, encryptionId=113c90584e6, topicName=观察性研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=34519379140, createdName=shock_melon, createdTime=Sun Feb 10 11:23:00 CST 2019, time=2019-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=360250, encodeId=78a536025048, content=学习了,谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sat Feb 09 10:47:10 CST 2019, time=2019-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046740, encodeId=cde21046e40f0, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Fri Feb 08 23:23:00 CST 2019, time=2019-02-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=360215, encodeId=ced4360215fa, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Feb 08 21:47:57 CST 2019, time=2019-02-08, status=1, ipAttribution=)]
    2019-02-08 天地飞扬

    了解一下,谢谢分享!

    0

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