Disability and Adverse Effects of Oral Versus Long-Acting Injectable Antipsychotics in Schizophrenia-Spectrum and Bipolar Disorder: A Comparison Based on Data-Driven Taxonomy

被引：2

作者：

Rodolico, Alessandro ^{[1
]}

Aprile, Sofia Francesca ^{[2
]}

Cutrufelli, Pierfelice ^{[3
]}

Privitera, Gabriele ^{[3
]}

Castellano, Sabrina ^{[2
]}

Concerto, Carmen ^{[3
]}

Furnari, Rosaria ^{[3
]}

Guerrera, Claudia Savia ^{[2
]}

Mineo, Ludovico ^{[3
]}

Platania, Giuseppe Alessio ^{[2
]}

Petralia, Antonino ^{[3
]}

Caraci, Filippo ^{[4
,5
]}

Signorelli, Maria Salvina ^{[3
,4
]}

机构：

[1] Tech Univ Munich, TUM Sch Med & Hlth, Dept Psychiat & Psychotherapy, Klinikum Rechts Isar, Munich, Germany

[2] Univ Catania, Dept Educ Sci, Sect Psychol, Via Teatro Greco 84, I-95124 Catania, Italy

[3] Univ Catania, Dept Clin & Expt Med, Psychiat Unit, Via Santa Sofia 78, I-95123 Catania, Italy

[4] IRCCS, Oasi Res Inst, Via Conte Ruggero 73, I-94018 Troina, Italy

[5] Univ Catania, Dept Drug & Hlth Sci, Via Valdisavoia 5, I-95123 Catania, Italy

来源：

CLINICAL DRUG INVESTIGATION | 2024年 / 44卷 / 09期

关键词：

ATYPICAL ANTIPSYCHOTICS; SIDE; MEDICATION; HEALTH; DRUGS; METAANALYSIS; RECEPTORS; BURDEN; IMPACT;

D O I：

10.1007/s40261-024-01391-x

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Background: Patients undergoing antipsychotic treatment for psychiatric disorders may experience challenges in functioning, either stemming from the severity of the illness or from the tolerability issues of prescribed medications. Objectives: The aims of this cross-sectional study are to investigate the impact of adverse effects of antipsychotic drugs on patients' daily life functioning, comparing oral and long-acting injectable (LAI) antipsychotics, and further dividing antipsychotics by receptor-binding profiles based on recently defined data-driven taxonomy. Methods: This study involved patients with schizophrenia and bipolar spectrum disorders taking oral or LAI antipsychotics. Disability and functioning levels were assessed using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS), and the adverse effects of medications were evaluated using the Udvalg for Kliniske Undersogelser (UKU) Side Effect Rating Scale and its subscales. Results: The total sample consisted of 126 participants with a diagnosis of schizophrenia-spectrum or bipolar disorder, and included 54 males and 72 females ranging from 18 to 78 years of age (mean 45.1, standard deviation 14); 78 patients were taking oral antipsychotics and 48 were taking LAI antipsychotics, with subcategories of muscarinic (31), adrenergic/low dopamine (25), serotonergic/dopaminergic (23), dopaminergic (1), LAI muscarinic (15), LAI adrenergic (6), and LAI serotonergic/dopaminergic (25). The UKU total score for adverse effects showed significant correlations with WHODAS total score (rho = 0.475; p < 0.001). Compared with oral antipsychotics, LAIs showed significantly lower scores in psychological (p = 0.014), autonomic (p = 0.008), other (p = 0.004), and sexual adverse effects (p = 0.008), as well as the UKU total score (p = 0.002). The Kruskal-Wallis test showed a significant difference in adverse effects between LAI and oral muscarinic subgroups, with LAIs having lower scores compared with antipsychotics binding to muscarinic receptors (p = 0.043). Conclusion: These findings indicate clinically relevant differences in adverse effects among formulations, warranting further investigation for future observational studies.

引用

页码：715 / 727

页数：13

共 45 条

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