背景:便秘是抗精神病药的常见不良反应,但是很少进行调查。我们的目的是在20年的时间内解决与精神分裂症患者开始使用泻药相关的因素。
方法:我们招募了2021年4月1日在每家医院就诊的精神分裂症患者(n=14),并回顾性检查了截至2016年4月1日、2011年、2006年和2001年的所有处方,从2021年开始每5年一次。716名具有完整数据的参与者被纳入分析。使用CochranQ检验以及Bonferroni校正和Cochran-Armitage趋势检验来确定每种泻药频率的差异和趋势。进行了多因素logistic回归分析,以评估20年内开始使用泻药的因素。
结果:在患者中,2001年有25.1%的人接受了泻药治疗,2021年有34.1%的人接受了泻药治疗。在过去的20年中,接受任何泻药治疗的患者数量显着不同,有显著的增长趋势。在所有泻药中,接受氧化镁治疗的患者数量,lubiprostone和elobixibat有显著的增长趋势。女性性别,年龄,总DZP等效剂量,和马来酸左甲丙嗪的剂量,奥氮平,喹硫平,zotepine,锂,2021年的卡马西平和卡马西平是20年期间开始使用泻药的重要因素.
结论:对于用马来酸左旋美丙嗪治疗的患者,需要仔细监测,奥氮平,喹硫平和佐替平.根据治疗指南优化处方可以减少抗精神病药物引起的便秘。
BACKGROUND: Constipation is a common adverse effect of antipsychotics, but little investigation has been conducted. We aimed to address the factors associated with the initiation of
laxative use in the same patients with schizophrenia over a 20-year period.
METHODS: We enrolled patients with schizophrenia attending each hospital (n = 14) from April 1, 2021, and retrospectively examined all prescriptions as of April 1, 2016, 2011, 2006, and 2001, every 5 years starting in 2021, for this population. 716 participants with complete data were included in the analysis. The Cochran Q test followed by Bonferroni correction and the Cochran-Armitage trend test were used to determine the differences and trends of the frequency of each
laxative. Multivariate logistic regression analysis was performed to assess the factors on the initiation of
laxative use over a 20-year period.
RESULTS: Of the patients, 25.1% were treated with laxatives in 2001, and 34.1% were treated in 2021. The numbers of patients treated with any laxatives significantly differed over the 20-year period, with a significant increasing trend. In all laxatives, the numbers of patients treated with magnesium oxide, lubiprostone and elobixibat differed with a significant increasing trend. Female sex, age, the total DZP equivalent dose, and the doses of levomepromazine maleate, olanzapine, quetiapine, zotepine, lithium, and carbamazepine in 2021 were significant factors associated with the initiation of
laxative use over the 20-year period.
CONCLUSIONS: Careful monitoring is needed for patients treated with levomepromazine maleate, olanzapine, quetiapine and zotepine. Optimizing prescriptions according to treatment guidelines could reduce antipsychotic-induced constipation.