СОВРЕМЕННЫЕ ВОЗМОЖНОСТИ ПСИХОФАРМАКОТЕРАПИИ НЕГАТИВНЫХ РАССТРОЙСТВ В КЛИНИКЕ ШИЗОФРЕНИИ
DOI:
https://doi.org/10.31082/1728-452X-2020-217-218-7-8-53-61Ключевые слова:
шизофрения, негативные расстройства, нейролептики, карипразинАннотация
Негативные симптомы при шизофрении оказывают значительное влияние на социальное и трудовое функционирование пациентов, могут препятствовать реабилитации, трудовой адаптации и социальной реинтеграции пациентов.
Основная часть. В статье освещены современные теоретические концепции негативных расстройств в клинике шизофрении и возможные подходы к терапии на примере нового атипичного антипсихотика карипразина (Реагила®).
Обсуждение. Улучшенный рецепторный профиль: высокая аффинность к D3-рецепторам и парциальный агонизм к обоим подтипам дофаминовых рецепторов может выступать в качестве базового механизма улучшения негативных симптомов.
Выводы. Карипразин - препарат выбора в терапии взрослых больных как в дебюте заболевания с преобладанием негативных расстройств, так и с хроническим течением шизофрении с продуктивными и негативными расстройствами, в том числе у пациентов с высоким риском метаболических и сердечно-сосудистых нарушений.
Библиографические ссылки
Statisticheskii sbornik Respublikanskii nauchno-prakticheskii tsentr psikhicheskogo zdorovia «Psikhiatricheskaia pomoshch naseleniiu RK»; 2017-2018. [Statistical collection of the Republican Scientific and Practical Center for Mental Health "Psychiatric assistance to the population of the Republic of Kazakhstan"; 2017-2018]. Available from: http://mentalcenter.kz/images/Statsbornik/Stat_sbornik_2017_2018_psych.docx
Altynbekov KS, Neznanov NG. Sovremennye podkhody k optimizatsii psikhiatricheskoi pomoshchi bolnym shizofreniei v Respublike Kazakhstan. [Modern approaches to the optimization of psychiatric care for patients with schizophrenia in the Republic of Kazakhstan]. Almaty: Publishing house LLP "Artikul"; 2017. 184 p.
Szkultecka-Dębek M, Walczak J, Augustyńska J. Epidemiology and Treatment Guidelines of Negative Symptoms in Schizophrenia in Central and Eastern Europe: A Literature Review. Clin Pract Epidemiol Ment Health. 2015;23(11):158–165. DOI: 10.2174/1745017901511010158
Becker RA, Bykov YuV, Morozov PV. Vydaiushchiesia psikhiatry XX veka [Outstanding psychiatrists of the XX century]. M.: Publishing House Gorodets; 2019. 256 p.
Becker RA, Bykov YuV, Morozov PV. Cariprazine as a socializing drug in schizophrenia (A Literature Review). Psikhiatriia i psikhofarmakoterapiia im. P.B. Gannushkina =Psychiatry and psychopharmacotherapy. 2020;22(2):16-24. (In Russ.)
Frye RE. Social Skills Deficits in Autism Spectrum Disorder: Potential Biological Origins and Progress in Developing Therapeutic Agents. CNS Drugs. 2018;32(8):713-734. DOI: 10.1007/s40263-018-0556-y
Harvey PD, Kleefe RS, Eesley CE. Neurocognition in Schizophrenia. In: Sadock BJ, Sadok VA, Raiz P. Kaplan & Sadock,s Comprehensive Textbook of Psychiatry, 2017.
Kirschner M. Secondary negative symptoms - A review of mechanisms, assessment and treatment. Schizophr Res. 2017;186:29-38. DOI: 10.1016/j.schres.2016.05.003
Bykov YuV, Becker RA, Morozov PV. The efficacy of cariprazine in the treatment of schizophrenia, especially with prominent or predominant negative symptoms. Psikhiatriia i psikhofarmakoterapiia im. P.B. Gannushkina = Psychiatry and psychopharmacotherapy. 2018;20(5):27-37. (In Russ.)
Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock's Comprehensive Textbook of Psychiatry. Lippincott Williams & Wilkins (LWW), 2017. ISBN: 978-1-45-110047-1
Pyatnitskiy NYu. «Primary», «basic» and «secondary» symptoms of schizophrenia in the concept of E. Bleuler. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = SS Korsakov Journal of Neurology and Psychiatry. 2017;117(8):88-97. (In Russ.). DOI: 10.17116/jnevro20171178188-97
Мосолов С.Н., Ялтонская П.А. Алгоритм терапии первичной негативной симптоматики при шизофрении // Современная терапия психических расстройств. - 2020. - №2. – C. 2-10. DOI: 10.21265/PSYPH.2020.26.17.001
Ktwis SF, Escalona R, Kcith SJ. Phenomenology of Schizophrenia. In: Sadock BJ, Sadok VA, Raiz P. Kaplan & Sadock,s Comprehensive Textbook of Psychiatry; 2017.
Mier D, Kirsch P. Social-Cognitive Deficits in Schizophrenia. Curr Top Behav Neurosc. 2017;30:397-409. DOI: 10.1007/7854_2015_427
Marder SR, Garderisi S. The current conceptualization of negative symptoms in schizophrenia. World Psychiatry. 2017;16(1):14-24. DOI: 10.1002/wps.20385
Durgam S, Earley W, Lu K, et al. Global improvement with cariprazine in the treatment of bipolar I disorder and schizophrenia: A pooled post hoc analysis. Int J Clin Pract. 2017;71(12): e13037. DOI: 10.1111/ijcp.13037
Frankel JS, Schwartz TL. Brexpiprazole and cariprazine: distinguishing two new atypical antipsychotics from the original dopamine stabilizer aripiprazole. Ther Adv Psychopharmacol. 2017;7(1): 29–41. DOI: 10.1177/2045125316672136
Roberts RJ, Findlay LJ, El-Mallakh PL, El-Mallakh RS. Update on schizophrenia and bipolar disorder: focus on cariprazine. Neuropsychiatr Dis Treat. 2016;12:1837–42. DOI: 10.2147/NDT.S97616
De Deurwaerdère P. Cariprazine: New dopamine biased agonist for neuropsychiatric disorders. Drugs Today (Barc). 2016;52(2):97–110. DOI: 10.1358/dot.2016.52.2.2461868
Citrome L. Cariprazine for the Treatment of Schizophrenia: A Review of this Dopamine D3-Preferring D3/D2 Receptor Partial Agonist. Clin Schizophr Relat Psychoses. 2016;10(2):109–19. DOI: 10.3371/1935-1232-10.2.109
Scarff JR. The prospects of cariprazine in the treatment of schizophrenia. Ther Adv Psychopharmacol. 2017;7(11):237–239. DOI: 10.1177/2045125317727260
EMA. EMA Public Assessment Report on Reagila; 2017. Available from: https://www.ema.europa.eu/documents/assessment-report/reagila-eparpublic-assessment-report_en.pdf.
Durgam S, Cutler AJ, Lu K, et al. Cariprazine in acute exacerbation of schizophrenia: a fixed-dose, phase 3, randomized, double-blind, placeboand active-controlled trial. J Clin Psychiatry. 2015;76(12): e1574–e1582. DOI: 10.4088/JCP.15m09997
Kane JM, Zukin S, Wang Y, et al. Efficacy and safety of cariprazine in acute exacerbation of schizophrenia: results from an International, phase III clinical trial. J Clin Psychopharmacol. 2015;35(4):367–373. DOI: 10.1097/JCP.0000000000000346.
Citrome L, Durgam S, Lu K, et al. The effect of cariprazine on hostility associated with schizophrenia: post hoc analyses from 3 randomized controlled trial. J Clin Psychiatry. 2016;77(1):109–115. DOI: 10.4088/JCP.15m10192
Earley W, Durgam S, Lu K, et al. Safety and tolerability of cariprazine in patients with acute exacerbation of schizophrenia: a pooled analysis of four phase II/III randomized, double-blind, placebo-controlled studies. Int Clin Psychopharmacol. 2017;32(6):319–328. DOI: 10.1097/YIC.0000000000000187
Zhao MJ, Qin B, Wang JB, et al. Efficacy and Acceptability of Cariprazine in Acute Exacerbation of Schizophrenia: Meta-Analysis of Randomized Placebo-Controlled Trials. J Clin Psychopharmacol. 2018;38(1):55–59. DOI: 10.1097/JCP.0000000000000834
Durgam S, Earley W, Li R, et al. Long-term cariprazine treatment for the prevention of relapse in patients with schizophrenia: A randomized, double-blind, placebo-controlled trial. Schizophr Res. 2016;176(2–3):264–271. DOI: 10.1016/j.schres.2016.06.030
Németh G, Laszlovszky I, Czobor P, et al. Cariprazine versus risperidone monotherapy for treatment of predominant negative symptoms in patients with schizophrenia: a randomised, double-blind, controlled trial. Lancet. 2017;389(10074):1103–13. DOI: 10.1016/S0140-6736(17)30060-0
Durgam S, Greenberg WM, Li D, et al. Safety and tolerability of cariprazine in the long-term treatment of schizophrenia: results from a 48-week, single-arm, open-label extension study. Psychopharmacology (Berl). 2017;234(2):199–209. DOI: 10.1007/s00213-016-4450-3
Krause M, Zhu Y, Huhn M, et al. Antipsychotic drugs for patients with schizophrenia and predominant or prominent negative symptoms: a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci. 2018;268(7):625-639. DOI: 10.1007/s00406-018-0869-3
