不同非典型抗精神病药严重不良反应监测及对策分析

Monitoring on the severe adverse reactions of different atypical antipsychotics and countermeasure analysis

目的探讨不同非典型抗精神病药的严重不良反应监测结果及防范对策。方法回顾分析十堰市中西医结合医院精神科2017年1月至2019年12月接收的行非典型抗精神病药治疗且发生严重不良反应1277例患者的临床资料,统计患者性别、年龄、各药物不良反应占比。结果奥氮平不良反应占比30.15%最高,依次为喹硫平、利培酮、氯氮平、阿立哌唑、帕利哌酮、氨磺必利、齐拉西酮。新的严重不良反应氯氮平19.61%占比最高;21~40岁不良反应占比58.73%最高;非典型抗精神病药不良反应累及系统及器官以肝胆系统损害29.13%占比最高。1277例患者不良反应好转1275例,后遗症肥胖1例,死亡1例。结论非典型抗精神病药治疗中易出现严重不良反应,对各个系统器官均造成损害,需加强对患者的用药监测及指导。

Objective To investigate the monitoring results of severe adverse reactions(ADRs)of different atypical antipsychotics and the countermeasures.Methods The clinical data of 1277 patients with severe ADRs treated with atypical antipsychotics admitted to the department of psychiatry of Shiyan Integrated Chinese and Western Medicine Hospital from January 2017 to December 2019 were reviewed.Meanwhile,the gender and age of patients as well as the proportion of ADRs of each drug were counted.Results ADRs of olanzapine accounted for 30.15%,which was the highest,followed by quetiapine,risperidone,clozapine,aripiprazole,paliperidone,sulfanilamide and ziprasidone.Clozapine accounted for 19.61%of the new serious ADRs,which was the highest proportion.ADRs of 21-40 years old accounted for 58.73%,which was the highest.ADRs of atypical antipsychotics involving the system and organs were the highest in hepatobiliary system damage,accounting for a proportion of 29.13%.Among 1277 patients,ADRs were improved in 1275 cases.Meanwhile,there was 1 case of sequela obesity and 1 case of death.Conclusion Atypical antipsychotics are prone to serious ADRs in the treatment,causing damage to all of the systems and organs,so it is necessary to strengthen the monitoring and guidance of patients'medication.