| アブストラクト | BACKGROUND AND HYPOTHESIS: Antipsychotics are first-line drug treatments for schizophrenia. When antipsychotic monotherapy is ineffective, combining two antipsychotic drugs is common although treatment guidelines warn of possible increases in side effects. Risks of metabolic side effects with antipsychotic polypharmacy have not been fully investigated. This study examined associations between antipsychotic polypharmacy and risk of developing diabetes, hypertension, or hyperlipidemia in adults with schizophrenia, and impact of co-prescription of first- and second-generation antipsychotics. STUDY DESIGN: A population-based prospective cohort study was conducted in the United Kingdom using linked primary care, secondary care, mental health, and social deprivation datasets. Cox proportional hazards models with stabilizing weights were used to estimate risk of metabolic disorders among adults with schizophrenia, comparing patients on antipsychotic monotherapy vs polypharmacy, adjusting for demographic and clinical characteristics, and antipsychotic dose. STUDY RESULTS: Median follow-up time across the three cohorts was approximately 14 months. 6.6% developed hypertension in the cohort assembled for this outcome, with polypharmacy conferring an increased risk compared to monotherapy, (adjusted Hazard Ratio = 3.16; P = .021). Patients exposed to exclusive first-generation antipsychotic polypharmacy had greater risk of hypertension compared to those exposed to combined first- and second-generation polypharmacy (adjusted HR 0.29, P = .039). No associations between polypharmacy and risk of diabetes or hyperlipidemia were found. CONCLUSIONS: Antipsychotic polypharmacy, particularly polypharmacy solely comprised of first-generation antipsychotics, increased the risk of hypertension. Future research employing larger samples, follow-up longer than the current median of 14 months, and more complex methodologies may further elucidate the association reported in this study. |
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| ジャーナル名 | Schizophrenia bulletin |
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| 投稿日 | 2023/8/25 |
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| 投稿者 | Eyles, Emily; Margelyte, Ruta; Edwards, Hannah B; Moran, Paul A; Kessler, David S; Davies, Simon J C; Bolea-Alamanac, Blanca; Redaniel, Maria Theresa; Sullivan, Sarah A |
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| 組織名 | The National Institute for Health Research Applied Research Collaboration West;(NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust,;Bristol, UK.;Population Health Sciences, Bristol Medical School, University of Bristol,;Centre for Addiction and Mental Health/University of Toronto, Toronto, ON,;Canada.;Women's College Hospital and University of Toronto, Toronto, ON, Canada. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37622178/ |
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