Second-generation antipsychotic-induced dystonia: Analysis using the Japanese Adverse Drug Event Report (JADER) database.

IF 5 3区 医学 Q1 CLINICAL NEUROLOGY Psychiatry and Clinical Neurosciences Pub Date : 2025-03-01 Epub Date: 2025-01-21 DOI:10.1111/pcn.13785
Takumi Ebina, Kunihiro Iwamoto, Masahiko Ando, Masashi Ikeda
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Abstract

Aim: This study aimed to explore the comparative risks for dystonia among different second-generation antipsychotics (SGAs), the influence of sex, and the relationship between the time-to-onset of dystonia and its outcomes.

Methods: We analyzed data from the Japanese Adverse Drug Event Report database from April 2004 to November 2023. Cases involving oral SGAs, excluding clozapine, were extracted. We used the odds ratios to assess the reporting proportions among SGAs and sex, analyzed the median time-to-onset and interquartile ranges (IQRs), and conducted a receiver operating characteristic (ROC) curve analysis to investigate the time-to-onset of dystonia and its relationship to outcomes.

Results: We extracted 9837 cases involving oral SGAs. Lurasidone was associated with a significantly higher proportion of dystonia reports than risperidone, aripiprazole, quetiapine, and olanzapine. The reporting proportion of dystonia associated with aripiprazole was lower than that of paliperidone and risperidone, but higher than that of quetiapine and olanzapine. Female sex was significantly associated with a higher reporting proportion of dystonia compared with males. Among the 148 cases of oral SGA-induced dystonia, the median time-to-onset was 125 days (IQR, 19.75-453.25 days). Divided into the three outcome groups (recovered, improved, and unrecovered/residual), those with better outcomes had a shorter time-to-onset than those with poorer outcomes. ROC curve analysis suggested a threshold of 91.5 days for discriminating outcomes, with a sensitivity of 71.7% and specificity of 69.9%.

Conclusions: The risks of dystonia may vary among SGAs and between sexes. SGA-induced dystonia often manifests in the tardive form.

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第二代抗精神病药物引起的肌张力障碍:使用日本不良药物事件报告(JADER)数据库进行分析。
目的:本研究旨在探讨不同第二代抗精神病药物(SGAs)对肌张力障碍的比较风险、性别的影响以及肌张力障碍发病时间与预后的关系。方法:分析2004年4月至2023年11月日本药品不良事件报告数据库中的数据。包括口服SGAs的病例,不包括氯氮平。我们使用优势比来评估SGAs和性别之间的报告比例,分析中位发病时间和四分位数范围(IQRs),并进行受试者工作特征(ROC)曲线分析来研究肌张力障碍的发病时间及其与结果的关系。结果:共提取口腔SGAs病例9837例。与利培酮、阿立哌唑、喹硫平和奥氮平相比,鲁拉西酮与肌张力障碍报告的相关比例明显更高。阿立哌唑组肌张力障碍报告比例低于帕利培酮和利培酮组,高于喹硫平和奥氮平组。与男性相比,女性患肌张力障碍的比例更高。148例口腔sga致肌张力障碍患者中位发病时间为125天(IQR, 19.75 ~ 453.25天)。分为三个结果组(恢复、改善和未恢复/残余),结果较好的患者比结果较差的患者发病时间短。ROC曲线分析显示,区分结果的阈值为91.5天,敏感性为71.7%,特异性为69.9%。结论:肌张力障碍的风险在SGAs和性别之间可能存在差异。sga诱发的肌张力障碍通常表现为迟发性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.40
自引率
4.20%
发文量
181
审稿时长
6-12 weeks
期刊介绍: PCN (Psychiatry and Clinical Neurosciences) Publication Frequency: Published 12 online issues a year by JSPN Content Categories: Review Articles Regular Articles Letters to the Editor Peer Review Process: All manuscripts undergo peer review by anonymous reviewers, an Editorial Board Member, and the Editor Publication Criteria: Manuscripts are accepted based on quality, originality, and significance to the readership Authors must confirm that the manuscript has not been published or submitted elsewhere and has been approved by each author
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