非典型抗精神病药-氨磺必利的临床研究进展
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摘要
药物治疗作为目前治疗精神分裂症的主要干预手段之一,已成为研究的主要突破点。我国上市不久的"老药"-氨磺必利,为治疗精神分裂症的非典型抗精神病药物,作用机制主要为选择性地拮抗多巴胺D_2/D_3受体,竞争性拮抗5-羟色胺受体,高度选择性作用于边缘系统。该药独有的作用机制使其对精神分裂症的阳性症状、阴性症状、情感性精神障碍如:抑郁症、双相障碍、阿尔茨海默病精神行为、酒精性精神障碍等病症都具有确切的疗效,能有效地提高患者的生活质量,且极少引起锥体外系反应,对泌乳素影响小,对体重、血脂及血糖几乎无影响,临床耐受性较好,可选为治疗精神分裂症的一线使用药物。本文通过查阅相关文献,对氨磺必利的药理作用、临床应用、不良反应等方面做一综述。
As one of the main intervention methods in the treatment of schizophrenia, drug therapy has become the main breakthrough point. Amisulpride is a atypical antipsychotic drugs for the treatment of schizophrenia. The mechanism of action is mainly to selectively antagonize dopamine D_2/D_3 receptor and the competitive antagonism of 5-serotonin receptors with the highly selective in limbic system. The drug has the unique mechanism of action of exact curative effect on positive symptoms, negative symptoms of schizophrenia and affective disorders, such as Depression, Bipolar disorder, Alzheimer 's disease, alcoholic psychosis and so on, which can effectively improve the quality of patients' life, and have little extrapyramidal reaction, little effect on prolactin, almost no effects on the weight, serum lipid and blood sugar, good tolerability. It can be used for first-line treatment of schizophrenia. Based on the pertinent literature, the pharmacological effects, clinical application and adverse reactions were reviewed in this paper.
As one of the main intervention methods in the treatment of schizophrenia, drug therapy has become the main breakthrough point. Amisulpride is a atypical antipsychotic drugs for the treatment of schizophrenia. The mechanism of action is mainly to selectively antagonize dopamine D_2/D_3 receptor and the competitive antagonism of 5-serotonin receptors with the highly selective in limbic system. The drug has the unique mechanism of action of exact curative effect on positive symptoms, negative symptoms of schizophrenia and affective disorders, such as Depression, Bipolar disorder, Alzheimer 's disease, alcoholic psychosis and so on, which can effectively improve the quality of patients' life, and have little extrapyramidal reaction, little effect on prolactin, almost no effects on the weight, serum lipid and blood sugar, good tolerability. It can be used for first-line treatment of schizophrenia. Based on the pertinent literature, the pharmacological effects, clinical application and adverse reactions were reviewed in this paper.
引文
[1]王真真,张有志,李云峰.抗精神分裂症药物的研究进展[J].军事医学,2013,8,37(8):628-631.
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[3]黄素培,张瑞岭,王来海,等.氨磺必利的药理学进展与临床应用评价[J].中国医院用药评价与分析,2011,11(8):679-683.
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[9]Komossa K,Rummel-Kluge C,Schwarz S,et al.Olanzapine versus other atypical antipsychotics for schizophrenia[J].Cochrane Database Syst Rev,2010,17(3):CD006654.
[10]洪汉林,段秀荣.帕罗西汀联合氨磺必利治疗伴精神病症状抑郁发作的效果评价[J].中外医疗,2016,14:23-25.
[11]梁瑞华,陆晓姿,冯玉芳.碳酸锂合并氨磺必利治疗双相障碍Ⅰ型抑郁发作的对照研究[J].四川精神卫生,2014,27(3):264-266.
[12]许越,于足,徐进.氨磺必利治疗阿尔茨海默病精神行为症状临床疗效观察及安全性评价[J].浙江中西医结合杂志,2016,26(9):814-816.
[13]徐民从.氨磺必利与丙戊酸镁缓释片治疗酒精性精神障碍的临床观察[J].河南科技大学学报(医学版),2014,32(4):285-287.
[14]易军,胡亚荣,万其容.氨磺必利联合氯氮平治疗难治性精神分裂症疗效和安全性分析[J].精神医学杂志,2014,27(4):278-280.
[15]周秋娟,吴晓燕.氨磺必利片致药疹1例[J].中国药物警戒,2013,10(9):575.
[16]王丽华,孙秀佳,陈美娟,等.氨磺必利致代谢相关不良反应的影响因素研究[J].精神医学杂志,2016,29(5):331-334.
[17]周慧民,韦德会.氨磺必利临床研究进展[J].医学综述,2017,23(2):323-326.
[18]康燕霞,陈景旭,魏立和,等.氨磺必利诱发Q-T间期延长1例[J].临床精神医学杂志,2012,22(1):39.
[2]沈一峰,李华芳,顾牛范.新型抗精神病药氨磺必利[J].中国临床药学杂志,2000,9(2):123-126.
[3]黄素培,张瑞岭,王来海,等.氨磺必利的药理学进展与临床应用评价[J].中国医院用药评价与分析,2011,11(8):679-683.
[4]程玉红,康江鹏,陈蔚,等.氨磺必利的合成[J].中国医药工业杂志,2011.42(11):801-802.
[5]段妮,刘彩兴.氨磺必利与喹硫平治疗首发精神分裂症的对照研究[J].四川精神卫生,2012,25(4):224-226.
[6]黄兴东,孙林.氨磺必利与氯丙嗪对精神病患者心电图影响的对照研究[J].实用药物与临床,2014,17(7):857-859.
[7]Abbas AI,Hedlund PB,Huang XP,et al.Amisulpride is a potent 5-HT7 antagonist:relevance for antidepressant actions in vivo[J].J Psychopharmacol(Berl),2009,205(1):119.
[8]魏立和,陈景旭.氨磺必利与利培酮治疗精神分裂症患者疗效及安全性对照研究[J].世界临床药物,2014,35(5):283-290.
[9]Komossa K,Rummel-Kluge C,Schwarz S,et al.Olanzapine versus other atypical antipsychotics for schizophrenia[J].Cochrane Database Syst Rev,2010,17(3):CD006654.
[10]洪汉林,段秀荣.帕罗西汀联合氨磺必利治疗伴精神病症状抑郁发作的效果评价[J].中外医疗,2016,14:23-25.
[11]梁瑞华,陆晓姿,冯玉芳.碳酸锂合并氨磺必利治疗双相障碍Ⅰ型抑郁发作的对照研究[J].四川精神卫生,2014,27(3):264-266.
[12]许越,于足,徐进.氨磺必利治疗阿尔茨海默病精神行为症状临床疗效观察及安全性评价[J].浙江中西医结合杂志,2016,26(9):814-816.
[13]徐民从.氨磺必利与丙戊酸镁缓释片治疗酒精性精神障碍的临床观察[J].河南科技大学学报(医学版),2014,32(4):285-287.
[14]易军,胡亚荣,万其容.氨磺必利联合氯氮平治疗难治性精神分裂症疗效和安全性分析[J].精神医学杂志,2014,27(4):278-280.
[15]周秋娟,吴晓燕.氨磺必利片致药疹1例[J].中国药物警戒,2013,10(9):575.
[16]王丽华,孙秀佳,陈美娟,等.氨磺必利致代谢相关不良反应的影响因素研究[J].精神医学杂志,2016,29(5):331-334.
[17]周慧民,韦德会.氨磺必利临床研究进展[J].医学综述,2017,23(2):323-326.
[18]康燕霞,陈景旭,魏立和,等.氨磺必利诱发Q-T间期延长1例[J].临床精神医学杂志,2012,22(1):39.