Antipsychotic-associated体重:管理策略和对治疗依从性的影响。

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Dayabandara M, Hanwella R, Ratnatunga年代,Seneviratne年代,Suraweera C, de Silva VA

Antipsychotic-associated体重:管理策略和对治疗依从性的影响。

Neuropsychiatr说请客。2017年8月22日,13:2231 - 2241。doi: 10.2147 / NDT.S113099。eCollection 2017。

PubMed ID

28883731 (在PubMed

]

文摘

Antipsychotic-induced体重增加对临床医师是一个重大的管理问题。它已经表明,体重增加和肥胖导致心血管和脑血管发病率和死亡率,减少生活质量和药物依从性差。本复习讨论各种抗精神病药物引起体重增加的倾向,可用药物和nonpharmacologic干预措施来抵消这种效应及其对依从性的影响。大多数抗精神病药物引起体重增加。似乎是风险最高的奥氮平与氯氮平。体重迅速增加后的最初阶段开始抗精神病药物。患者长期继续增加体重。孩子似乎特别容易受到antipsychotic-induced体重增加。裁剪抗精神病药物根据个人的需要和密切监测体重和其他代谢参数在一开始是最好的预防策略。切换到一个代理倾向较小导致体重增加是选项之一,但携带疾病的复发的风险。 Nonpharmacologic interventions of dietary counseling, exercise programs and cognitive and behavioral strategies appear to be equally effective in individual and group therapy formats. Both nonpharmacologic prevention and intervention strategies have shown modest effects on weight. Multiple compounds have been investigated as add-on medications to cause weight loss. Metformin has the best evidence in this respect. Burden of side effects needs to be considered when prescribing weight loss medications. There is no strong evidence to recommend routine prescription of add-on medication for weight reduction. Heterogeneity of study methodologies and other confounders such as lifestyle, genetic and illness factors make interpretation of data difficult.

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药物

齐拉西酮