Comparative analysis of third-generation antipsychotics in first-episode schizophrenia: efficacy, safety, and cognitive impacts. A narrative review.

IF 2.1 3区医学 Q3 PHARMACOLOGY & PHARMACY

International Clinical Psychopharmacology Pub Date : 2024-06-14 DOI:10.1097/YIC.0000000000000559

Valerio Ricci, Alessandro Sarni, Giovanni Martinotti, Giuseppe Maina

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Abstract

Background and objectives: Schizophrenia is a chronic, complex mental health disorder requiring effective management to mitigate its broad personal and societal impacts. This narrative review assesses the efficacy, effectiveness, and side effects of third-generation antipsychotics (TGAs) like aripiprazole, brexpiprazole, and cariprazine, focusing on their use in first-episode schizophrenia. These drugs aim to reduce side effects typical of earlier antipsychotics while more effectively addressing positive and cognitive symptoms.

Methods: Our extensive literature review, using PubMed and Scopus, includes randomized controlled trials and observational studies, showing TGAs may match older antipsychotics in efficacy with fewer side effects, notably in reducing extrapyramidal symptoms and enhancing cognitive outcomes.

Results: Aripiprazole appears effective in both acute and maintenance phases of schizophrenia, while brexpiprazole and cariprazine show potential in managing negative symptoms and improving social functioning, essential for patient recovery.

Conclusions: This review emphasizes the need for personalized treatment and further research to fully determine the long-term benefits and safety of TGAs. These findings can inform clinical decisions and underline the ongoing need for innovation in schizophrenia pharmacotherapy.

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第三代抗精神病药物对首发精神分裂症的比较分析：疗效、安全性和认知影响。叙述性综述。

背景和目标：精神分裂症是一种慢性、复杂的精神疾病，需要有效的治疗以减轻其对个人和社会的广泛影响。这篇叙述性综述评估了阿立哌唑、布雷哌唑和卡哌嗪等第三代抗精神病药物（TGAs）的疗效、有效性和副作用，重点关注它们在首发精神分裂症中的应用。这些药物旨在减少早期抗精神病药物的典型副作用，同时更有效地解决阳性症状和认知症状：我们利用PubMed和Scopus进行了广泛的文献综述，其中包括随机对照试验和观察性研究，结果表明TGAs的疗效可与较早的抗精神病药物媲美，但副作用较少，尤其是在减少锥体外系症状和增强认知功能方面：结果：阿立哌唑似乎对精神分裂症的急性期和维持期均有效，而布拉克哌唑和卡哌嗪则在控制阴性症状和改善社会功能方面显示出潜力，这对患者的康复至关重要：本综述强调了个性化治疗和进一步研究的必要性，以充分确定 TGAs 的长期益处和安全性。这些研究结果可为临床决策提供依据，并强调精神分裂症药物治疗需要不断创新。

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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.