|
|
|
| Effects of atypical antipsychotics on blood thyroid hormones and lipids in children and adolescents with schizophrenia |
| DUAN Xiaxia1 ZHANG Yan2 ZHANG Meng1 YU Yanju1 |
1.Clinical Laboratory, Xi′an Mental Health Center, Shaanxi Province, Xi′an 710100, China;
2.Pharmacy Laboratory, Xi′an Mental Health Center, Shaanxi Province, Xi′an 710100, China |
|
|
|
Abstract Objective To investigate the effects of atypical antipsychotics on blood thyroid hormones and lipids in children and adolescents with schizophrenia. Methods From September 2015 to July 2017, the clinical data of inpatients in the Department of Child and Adolescent Psychology in Xi′an Mental Health Center was analyzed retrospectively. A total of 86 patients with application of single drug were selected and divided into the Aripiprazole group (29 cases), the Olanzapine group (29 cases) and the Risperidone group (28 cases) according to different drugs they took. Each group was given drugs from small doses for 6 weeks. Before and after treatment, the levels of thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4), triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL) and low density lipoprotein (LDL) were analyzed, and the efficacy and safety of each drug were evaluated by positive and negative symptoms scale (PANSS) and treatment emergent symptom scale (TESS). Results ①After treatment, the scores of PANSS in the three groups were significantly lower than those before treatment (P ＜ 0.01). ②In Olanzapine group, the levels of TC, TG, LDL and HDL were significantly higher than those before treatment (P ＜ 0.01 or P ＜ 0.05), while T4 and FT4 were significantly lower than those before treatment (P ＜ 0.01); in Risperidone group, LDL was significantly higher than that before treatment (P ＜ 0.01), and T3 and T4 were significantly lower than those before treatment (P ＜ 0.05); Aripiprazole had no significant differences on blood lipids and thyroid hormones (P ＞ 0.05). ③Comparison among the three groups showed that Olanzapine had the greatest effect on lipids, and Risperidone had the greatest effect on T3. ④There was no significant difference of the incidence of adverse reactions among the three groups (P > 0.05). Conclusion Aripiprazole, Olanzapine and Risperidone have significant therapeutic effects on children and adolescents with schizophrenia. Aripiprazole has no significant effect on blood lipids and thyroid hormones, Olanzapine affects blood lipids significantly, Risperidone affects T3 significantly.
|
|
|
|
|
|
[1] 杨楹.儿童精神分裂症5年预后及社会功能康复影响因素的前瞻性研究[D].济南：山东大学，2017.
[2] Glick HA，Li P，Harvey PD. The relationship between Positive and Negative Syndrome Scale（PANSS）schizophrenia severity scores andrisk for hospitalization：an analysis of the CATIE Schizophrenia Trial [J]. Schizophr Res，2015， 166（1-3）：110-114.
[3] 王秀珍，孙太鹏，黄成兵，等.258例儿童青少年精神分裂症住院患者药物治疗现状[J].国际精神病学杂志，2018， 45（2）：247-249.
[4] Kay SR，Fiszbein A，Opler LA. The positive and negative syn-drome scale（PANSS）for schizophrenia [J]. Schizophrenia Bull，1987，13（2）：261.
[5] 刘卫东，朱转娥，叶秀萍，等.精神分裂症患者出院后维持服药观察及影响因素分析[J].临床精神医学杂志，2011， 21（3）：165-167.
[6] 邹凯，赵幸福，易峰，等.长期服用抗精神病药的男性精神分裂症患者骨密度与血清泌乳素的关系[J].临床精神医学杂志，2015，25（6）：412-414.
[7] 陈建军.非典型抗精神病药治疗精神分裂症的临床分析与研究[J].世界最新医学信息文摘，2017，17（25）：132-134.
[8] 张莉，马燕娟，杨超，等.早发性精神分裂症临床症状与甲状腺激素水平的相关分析[J].中国健康心理学杂志，2017，25（7）：977-980.
[9] 周晓亮，张静，黄劲松.不同症状精神分裂症患者治疗前后甲状腺激素水平的影响研究[J].中国预防医学杂志，2017，18（5）：388-390.
[10] 张淑芬，兰光华.奥氮平、奎硫平与阿立哌唑对精神分裂症患者血清甲状腺激素和催乳素水平的影响[J].临床精神医学杂志，2015，25（1）：51-53.
[11] 赵明坤，刘叶红，张平，等.利培酮对精神分裂症患者血脂和甲状腺激素的影响[J].中国临床药理学杂志，2015， 31（5）：342-344.
[12] 赵明坤，周雪丽，杨叶.奥氮平对精神分裂症患者甲状腺素和血脂的影响[J].精神医学杂志，2012，25（6）：449-450.
[13] Newman-Tancredi A，Kleven MS. Comparative pharmacology of antipsychotics possessing combined dopamine D2 and serotonin 5-HT1A receptor properties [J]. Psycho Pharmacology（Berl），2011，216（4）：451-473.
[14] 刘丽红.阿立哌唑的药理作用及治疗精神分裂症的疗效观察[J].中国继续医学教育，2015，7（9）：216-217.
[15] 王雁芬，陈晓慧，孙平平，等.阿立哌唑、喹硫平和利培酮对精神分裂症患者甲状腺素水平的影响[J].精神医学杂志，2014，27（1）：45-47.
[16] 王雪诗，徐成爱，李申，等.非典型抗精神病药导致体质量增加与甲状腺功能的相关研究[J].天津医科大学学报，2017，23（2）：174-177.
[17] 叶爱梅.帕利哌酮缓释片治疗首发精神分裂症的临床疗效分析[J].中国现代医生，2017，55（23）：77-79，83.
[18] 石洲宝，刘海涛，刘成松，等.安神胶囊治疗精神分裂症患者睡眠障碍临床研究[J].西部中医药，2017，30（3）：5-8.
[19] 刘彩兴.四种非典型抗精神病药对精神分裂症患者血清催乳素和血脂影响的研究[D].苏州：苏州大学，2011.
[20] 梁启勇，苏冠环，陈梓朗，等.门诊首发精神分裂症应用齐拉西酮和利培酮治疗的疗效观察[J].中国医药科学，2018，8（2）：33-35，96.
[21] Nicol GE，de Las Fuentes L，Riek AE，et al. Adiposity and cardiometa-bolic risk in children with and without antipsychotic drug treatment [J]. J Clin Endocrinol Metab，2015，100（9）：3418-3426.
[22] Romo-Nava F，Alvarez-Icaza González D，Fresán-Orellana A，et al. Melatonin attenuates antipsychotic metabolic effects：an eight-week randomized，double-blind，parallel-group，placebo-controlled clinical trial [J]. Bipolar Disord，2014，16（4）：410-421.
[23] 虞贝贝，夏志敏，杨盛洲，等.利培酮对精神分裂症患者血脂和泌乳素水平的影响[J].中国现代医生，2017，55（34）：101-103.
[24] Citrome L，Kalsekar I，Baker RA，et al. A review of real-world data on the effects of aripiprazole on weight and metabolic outcomes in adults [J]. Curr Med Res Opin，2014，30（8）：1629-1641.
[25] 谢滨浩，姚赛华，杜育如，等.阿立哌唑与认知行为联合应用于首发精神分裂症患者对认知功能的改善作用[J].中国医药科学，2017，7（15）：230-232.
[26] 莫亚莉，夏泳，陶云海，等.3种非典型抗精神病药对首发精神分裂症患者血糖血脂、泌乳素、甲状腺激素的影响[J].中华全科医学，2017，15（3）：479-482.
[27] 汤庆军.阿立哌唑与奥氮平对首发精神分裂症患者体质量及糖脂代谢影响的对比研究[J].精神医学杂志，2011， 24（5）：348-349.
[28] 樊凌姿，宋丽，冯菊平.喹硫平与阿立哌唑对精神分裂症患者糖脂代谢影响的对照观察[J].中国实用神经疾病杂志，2011，14（7）：10-12.
[29] Smith H，Kenney-Herdert J，Knowles L. Clozapine-induced diabetic ketoacidosis [J]. Aust New Zealand J Psychiatry，1999，33（1）：120-122. |
|
|
|
