Efficacy and safety profiles of mood stabilizers and antipsychotics for bipolar depression: a systematic review.

IF 2.1 3区医学 Q3 PHARMACOLOGY & PHARMACY International Clinical Psychopharmacology Pub Date : 2023-07-01 DOI:10.1097/YIC.0000000000000449

Luyao Cai, Guanjie Chen, Haichen Yang, Yuanhan Bai

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引用次数: 4

Abstract

The whole picture of psychotropics for bipolar depression (BPD) remains unclear. This review compares the differences in efficacy and safety profiles among common psychotropics for BPD. MEDLINE, EMBASE, and PsycINFO were searched for proper studies. The changes in the depressive rating scale, remission/response rates, nervous system adverse events (NSAEs), gastrointestinal adverse events (GIAEs), metabolic parameters, and prolactin were compared between medication and placebo or among medications with the Cohen's d or number needed to treat/harm. The search provided 10 psychotropics for comparison. Atypical antipsychotics (AAPs) were superior to lithium and lamotrigine at alleviating acute depressive symptoms. Lithium was more likely to induce dry mouth and nausea. Cariprazine and aripiprazole seemed to be associated with an increased risk of akathisia and upper GIAEs. Lurasidone was associated with an increased risk of developing akathisia and hyperprolactinemia. Olanzapine, olanzapine-fluoxetine combination (OFC), and quetiapine were associated with an increased risk of NSAEs, metabolic risk, dry mouth, and constipation. Cariprazine, lurasidone, OFC, or quetiapine was optimal monotherapy for BPD. Further studies are needed to assess the efficacy and safety of lamotrigine for treating BPD. Adverse events varied widely across different drug types due to variations in psychopharmacological mechanisms, dosages, titration, and ethnicities.

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情绪稳定剂和抗精神病药物治疗双相抑郁症的有效性和安全性:一项系统综述。

精神药物治疗双相抑郁症(BPD)的整体情况仍不清楚。本综述比较了常见精神药物治疗BPD的疗效和安全性差异。检索MEDLINE、EMBASE和PsycINFO以寻找合适的研究。比较药物与安慰剂或具有Cohen's d或治疗/伤害所需数量的药物在抑郁评定量表、缓解/反应率、神经系统不良事件(NSAEs)、胃肠道不良事件(giae)、代谢参数和催乳素方面的变化。研究提供了10种精神药物进行比较。非典型抗精神病药物(AAPs)在缓解急性抑郁症状方面优于锂和拉莫三嗪。锂更容易引起口干和恶心。卡吡嗪和阿立哌唑似乎与肌静坐障碍和上giae的风险增加有关。鲁拉西酮与发生静坐障碍和高泌乳素血症的风险增加有关。奥氮平、奥氮平-氟西汀联合(OFC)和喹硫平与NSAEs、代谢风险、口干和便秘风险增加相关。卡吡嗪、鲁拉西酮、OFC或喹硫平是BPD的最佳单药治疗。需要进一步的研究来评估拉莫三嗪治疗BPD的有效性和安全性。由于精神药理学机制、剂量、滴定和种族的差异，不同药物类型的不良事件差异很大。

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

International Clinical Psychopharmacology 医学-精神病学

CiteScore

4.40

自引率

23.10%

发文量

审稿时长

>12 weeks

期刊介绍： International Clinical Psychopharmacology provides an essential link between research and clinical practice throughout psychopharmacology. It reports on studies in human subjects, both healthy volunteers and patients, which relate the effects of drugs on psychological processes. A major objective of the journal is to publish fully refereed papers which throw light on the ways in which the study of psychotropic drugs can increase our understanding of psychopharmacology. To this end the journal publishes results of early Phase I and II studies, as well as those of controlled clinical trials of psychotropic drugs in Phase II and IV. Other topics covered include the epidemiology of psychotropic drug prescribing and drug taking, the sociology of psychotropic drugs including compliance, and research into the safety and adverse effects of these compounds.