背景:高达34%的精神分裂症患者对几种治疗试验耐药。缺乏持续和适当的治疗与复发有关,再住院,抗精神病药物治疗的效果较低,副作用的风险更高。长效注射抗精神病药(LAIAP)可提高精神分裂症患者的依从性并改善临床结果和生活质量,因此,在难治性精神分裂症的病例中,建议同时施用两种LAIAP。这篇综述的目的是总结有关精神分裂症或其他精神病谱系障碍患者联合使用两种LAIAP的现有文献。
方法:从开始到2024年2月9日,在PubMed上对有关两种长效可注射抗精神病药的任何组合的相关文章进行了广泛的文献搜索,Scopus和APAPsycInfo,根据PRISMA声明。仅选择报告两种LAIAP的组合及其在精神分裂症和相关疾病患者中的临床结果的研究。
结果:在选择过程之后,九例病例报告,4项病例系列和2项观察性回顾性研究纳入了最终分析.所有接受双LAIAP治疗的患者均报告反应良好,并且没有报告由于两种LAI的组合而产生的新的或意外的不良反应。使用了不同的药物组合,最常见的关联导致阿立哌唑一水合物+帕潘立酮棕榈酸酯每月一次(32次)。
结论:我们的综述强调了两种并发LAIAP的治疗方案已经在临床实践中广泛使用,并被认为是一种有前途的治疗方案,有效,和相对安全的治疗精神分裂症谱系障碍的治疗策略。
BACKGROUND: Up to 34% of patients with schizophrenia are resistant to several treatment trials. Lack of continuous and adequate treatment is associated with relapse, rehospitalization, a lower effect of antipsychotic therapy, and higher risk of side effects. Long-acting injectables antipsychotics (LAI APs) enhance compliance and improve clinical outcomes and quality of life in patients with schizophrenia, and thus it may be advisable to administer two LAI APs at the same time in cases of treatment-resistant schizophrenia. The purpose of this review is to summarize the available literature regarding the combined use of two LAI APs in patients with schizophrenia or other psychotic spectrum disorders.
METHODS: An extensive literature search for relevant articles regarding any combination of two long-acting injectable antipsychotics has been performed from inception up to 9 February 2024, on PubMed, Scopus and APA PsycInfo, according to the PRISMA statement. Only studies reporting combination of two LAI APs and its clinical outcome in patients with schizophrenia and related disorders were selected.
RESULTS: After the selection process, nine case reports, four case series and two observational retrospective studies were included in the final analysis. All patients treated with dual LAI APs reported a good response, and no new or unexpected adverse effects due to the combination of two LAIs were reported. Different drug combinations were used, and the most frequent association resulted in aripiprazole monohydrate + paliperidone palmitate once monthly (32 times).
CONCLUSIONS: Our review highlights that the treatment regimen with two concurrent LAI APs is already widely used in clinical practice and is recognized as providing a promising, effective, and relatively safe therapeutic strategy for treating the schizophrenia spectrum disorders.