Abstract

Background

Side effects restrict the optimal use of antipsychotics. Little is known about the influence of substance use on side effects. The aim of this study was to compare antipsychotic side effects in patients with psychosis with and without substance use, while also taking medication history and diagnosis into consideration.

Methods

All patients (n = 226, mean age 34, females 33%) diagnosed with schizophrenia spectrum disorders (SSD; F20–F29) or other psychosis (F30-F32; F10-F19), were treated with olanzapine, quetiapine, risperidone or ziprasidone, and were assessed at baseline, 4-weeks, 14-weeks, and 27-weeks. The UKU-Side Effects Self-Rating Scale version was used to evaluate the side effect profiles, and the information on substance use was based on the Clinician Drug Use Scale.

Results

At baseline, 30% of the patients used substances, 54% were diagnosed with SSD, and 47% were antipsychotic naïve. The occurrence of side effects in total was not different in patients with substance use compared to without after 4-weeks of treatment, nor in the follow-up period. At 4-weeks there were some group differences in relation to substance use, diagnosis, and medication history for single side effects. Patients with substance use showed more increased dream activity, less reduced salivation, and more gynecomastia. Patients with SSD showed less neurological side effects, orgasm dysfunction, and tension/inner unrest. The medication naïve patients showed increased hypokinesia/akinesia.

Conclusion

Substance use alone does not influence the general magnitude of side effects of antipsychotic medication and does not indicate a different prescription practice in patients with psychosis and substance use.

中文翻译：

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物质使用对奥氮平、喹硫平、利培酮和齐拉西酮在精神病中的副作用的影响

摘要

背景

副作用限制了抗精神病药的最佳使用。关于物质使用对副作用的影响知之甚少。本研究的目的是比较有和没有物质使用的精神病患者的抗精神病药物副作用，同时还要考虑用药史和诊断。

方法

所有 诊断为精神分裂症谱系障碍（SSD；F20-F29）或其他精神病（F30-F32；F10-F19）的患者（n = 226，平均年龄 34，女性 33%）均接受奥氮平、喹硫平、利培酮或齐拉西酮治疗，并在基线、4 周、14 周和 27 周时进行评估。UKU-Side Effects Self-Rating Scale 版本用于评估副作用概况，关于物质使用的信息基于临床医生药物使用量表。

结果

在基线时，30% 的患者使用过药物，54% 被诊断为 SSD，47% 未使用抗精神病药。在治疗 4 周后，或在随访期间，物质使用患者与未使用的患者相比，总体副作用的发生率没有差异。在 4 周时，在药物使用、诊断和单一副作用的用药史方面存在一些组差异。物质使用的患者表现出更多的梦想活动，更少的唾液减少和更多的男性乳房发育。SSD 患者表现出较少的神经系统副作用、性高潮功能障碍和紧张/内心不安。未接受药物治疗的患者表现出运动机能减退/运动不能症增加。

结论

单独使用物质不会影响抗精神病药物副作用的一般程度，也不表明精神病和物质使用患者的处方做法不同。