阿立哌唑治疗女性精神分裂症的研究现状

Research status of aripiprazole in the treatment of female schizophrenia

精神分裂症(SCH)是一种常见的病因未完全阐明的重性精神疾病,多起病于青壮年,常有知觉、行为、情感和思维等方面的障碍,一般无意识和智能障碍,病程迁延,呈进行性衰退。与男性患者相比,女性SCH患者的发病年龄晚,症状较轻,但更容易发生肥胖、高脂血症、2型糖尿病和高催乳素(PRL)血症等,严重危害女性的身体健康。阿立哌唑(ARI)于2002年获美国食品药品监督管理局批准用于治疗SCH,是多巴胺D2和5-羟色胺1A受体的部分激动药,安全性好,药物不良反应轻微可逆,对PRL和代谢影响小,是治疗年轻女性SCH患者的一线用药。本文就女性SCH患者的患病率、临床特点、雌激素神经保护作用和开展乳腺癌筛查的必要性,ARI治疗女性SCH的疗效和安全性的循证证据等做一综述。

Schizophrenia is a severe mental disease for which the etiology is unknown. This disease often happens in young adults who are usually accompanied by the disorders of perception, behavior, emotion, and thinking. They usually don’t show signs of awareness or intelligence problems, but the disease has a lengthy and gradual course. Compared to male patients, female patients experience a delayed onset of disease. Despite the fact that females’ symptoms are modest, they are more likely to develop obesity, hyperlipidemia, type 2 diabetes and hyperprolactinemia, all of which are severe health risks for women. Aripiprazole, a partial agonist of dopamine D2 and 5-hydroxytryptophan 1 A receptors, was approved by the Food and Drug Administration for the treatment of schizophrenia in 2002. Aripiprazole is a first-line drug for young women with schizophrenia that has high safety, minor transient side effects, and little impact on prolactin and metabolism. This paper summarizes the prevalence, clinical features, estrogen’s neuroprotective effects, the necessity of breast cancer screening, efficacy, and safety of aripiprazole in the treatment of female schizophrenia.