女性精神分裂症患者的抗精神病药物临床应用进展

Clinical Application Advances of Antipsychotic Drugs in Female Schizophrenic Patients

女性精神分裂症患者吸收、排泄速度较慢,导致抗精神病药物在其体内的血药浓度较高,进而引发更多的药物副作用。女性在不同生命阶段的雌激素水平也不同,雌激素通过增加多巴胺D 2受体敏感性,提高抗精神病药物的疗效。应根据雌激素水平的高低调整抗精神病药物的剂量,同时做好血糖、三酰甘油、胆固醇、催乳素等指标的监测,以最大程度地减少药物副作用。作者未见文献报道适用于不同性别的精神分裂症治疗方案,这对女性患者来说并不是最佳治疗策略。该综述旨在对女性精神分裂症患者的处方、药动学、药效学、疗效和副作用的差异进行总结与归纳,并针对不同生命阶段(绝经前、妊娠期、哺乳期、绝经期)女性的药物治疗方案提出科学建议。

Female patients with schizophrenia exhibit a slower rate of absorption and excretion,leading to higher blood levels of antipsychotic drugs in their bodies and consequently causing more drug side effects.Women also have different levels of estrogen at different stages of life,and estrogen improves the efficacy of antipsychotic drugs by increasing dopamine D 2 receptor sensitivity.It is necessary to adjust the dosage of antipsychotic medication based on the level of estrogen,while also monitoring indicators such as blood glucose,triglycerides,cholesterol,and prolactin to minimize medication side effects.Nevertheless,the current literatures do not provide specific treatment plans for schizophrenia tailored to different genders,which is not the optimal treatment strategy for female patients.This review aims to summarize and categorize the differences in prescription,pharmacokinetics,pharmacodynamics,efficacy,and side effects in female patients with schizophrenia,and to provide scientific recommendations for drug treatment strategies in different stages of a woman's life(premenopausal,pregnancy,lactation,postmenopausal).