[血液病患者精神障碍的精神药物治疗:安全问题]

D E Vybornykh, S V Ivanov, E G Gemdzhian, T V Gaponova
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引用次数: 0

摘要

目的:评价现代血液病治疗方案中精神障碍精神药物治疗的安全性。材料与方法:对552例在国家血液学医学研究中心门诊接受PFT治疗的血液病患者的病历资料进行分析。考虑到服用PFT时记录的任何不良事件。统计分析包括描述性统计、频率分析和评估(学生t检验)血液参数的变化(服用精神药物前后)。结果:仅7.1% (n=37)例患者在使用苯二氮卓类药物(n=12)联合血液毒性药物治疗血液病时发现血液毒性体征。在4.8% (n=25)例中检测到其他显著不良事件(导致过早停药或剂量减少),其中9例与抗焦虑药(羟嗪、佐匹克隆)有关,11例与抗抑郁药(氯米帕明、阿米替林、度洛西汀、曲唑酮、去甲硫氨酸)有关,5例与抗精神病药(利培酮、阿利咪嗪、氟哌啶醇)有关。结论:大多数精神药物对血液病患者发生的精神病理障碍是有效的,并且在官方使用说明规定的日剂量范围内以最小/平均治疗剂量使用是安全的。
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[Psychopharmacotherapy of mental disorders in hematological patients: security concerns].

Objective: Evaluation of the safety of psychopharmacotherapy (PFT) of mental disorders in modern protocols for the treatment of patients with blood disorders.

Material and methods: The data of medical records of 552 patients with blood disorders who received PFT during treatment at the clinic of the National Medical Research Center for Hematology were analyzed. Any adverse events recorded while taking PFT were taken into account. Statistical analysis included descriptive statistics, frequency analysis, and assessment (Student's t-test) of changes in blood parameters (before and after taking psychotropic drugs).

Results: Signs of hematotoxicity were found only in 7.1% (n=37) patients, in all cases while taking benzodiazepines (n=12) in combination with hematotoxic drugs for the treatment of blood disorders. Other significant adverse events (which caused premature discontinuation or dose reduction) were detected in 4.8% (n=25) cases, of which 9 were associated with the appointment of anxiolytics (hydroxyzine, zopiclone), 11 with antidepressants (clomipramine, amitriptyline, duloxetine, trazodone, ademethionine) and 5 with antipsychotics (risperidone, alimemazine, haloperidol).

Conclusion: Most psychotropic drugs are effective in relation to psychopathological disorders that develop in hematological patients and are safe when used at minimum/average therapeutic doses within the daily dosage ranges established by the official instructions for use.

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Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova Medicine-Psychiatry and Mental Health
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