摘要
常用的非典型抗精神病药物有:阿立哌唑、氯氮平、奥氮平、奎硫平、利培酮及齐拉西酮。非典型抗精神病药物的药代动力学和不良反应均有性别差异。女性的CYP1A2酶的活性较男性低,致氯氮平和奥氮平的血药浓度高于男性。利培酮引起女性高催乳素水平,导致女性骨质疏松和性功能障碍的发生率高于男性。研究表明,非典型抗精神病药物使女性代谢综合征的发生率明显高于男性。其中女性和男性肥胖症、高血压、三酰甘油血症及高密度脂蛋白降低的发生率分别为76.3%和35.5%,46.9%和47.2%,42.2%和50.7%,48.9%和63.3%;女性和男性高血糖[≥100mg/dl(5.55mmol/L)和≥110mg/dl(6.10mmol/L)]的发生率分别为30.0%和21.7%,24.2%和14.1%。非典型抗精神病药物引起心电图QTc间期延长及锥体外系症状女性较男性多见;其中某些药物对胎儿有不良影响。
The common atypical antipsychotics are aripiprazole, clozapine, olanzapine, quetiapine, fispefidone, and ziprasidone. Sex differences are presented in the pharmacokinetics and adverse reactions of atypical antipsychotics. Because of the lower CYP1A2 activity in women, the plasma clozapine and olanzapine concentrations are higher in women than in men. Risperidone causes hyperprolactinaemia in women, which lead to higher incidence rates of osteoporosis and sexual dysfunction in women than in men. Studies suggest that the incidence rate of metabolic syndrome is higher in women than in men： the incidence rates of obesity, hypertension, hypertfiglyeefidemia and decreased HDL level in women and men are 76.3% vs 35.5% , 46.9% vs 47.2% , 42.2% vs 50.7%, 48.9% vs 63.3%, respectively; the incidence rates of hyperglycemia [≥100 mg/dl （5.55 retool/L） and ≥ 110 mg/dl （6. 10 retool/L） ] in women and in men are 30.0% vs 21.7% and 24.2% vs 14.1%, respectively. The incidence rates of prolonged QTc interval and extrapyramidal symptoms of atypical antipsychotics are higher in women than in men. Some atypical antipsychotics have adverse effects to the fetus.
出处
《药物不良反应杂志》
2008年第2期110-115,共6页
Adverse Drug Reactions Journal
