与第二代抗精神病药物相关的糖尿病酮症酸中毒:病例研究与文献综述。

IF 1.8 4区 医学 Q3 PSYCHIATRY
Psychiatry Investigation Pub Date : 2024-02-01 Epub Date: 2024-02-22 DOI:10.30773/pi.2023.0301
Heewon Bae, Ji Hyun Lee, Sungsuk Je, Seung-Hoon Lee, Hayun Choi
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引用次数: 0

摘要

目的:第二代抗精神病药物(SGAs)彻底改变了精神疾病的治疗方法,但与糖尿病和高血糖危机等重大代谢风险相关。这篇综述探讨了抗精神病药物、糖尿病和高血糖危机之间复杂的相互作用,强调了SGA诱发糖尿病的机制:我们介绍了一例正在服用抗精神病药物的精神分裂症患者的病例,该患者因突然发生糖尿病酮症酸中毒(DKA)而被送入急诊室,但没有任何糖尿病病史。我们在 Elsevier、PubMed、IEEE、SpringerLink 和 Google Scholar 等数据库中广泛检索了 2002 年至 2021 年期间有关抗精神病药物对 DKA 影响的论文。我们重点研究了 DKA、高血糖和非典型抗精神病药物,共检索到 117 篇论文。经过全文审阅,32篇论文被纳入本综合综述:服用 SGAs 的患者发生 DKA 的频率明显更高。抗精神病药物可直接或通过肥胖的发生诱发胰岛素抵抗。抗精神病药物可减少胰岛β细胞的胰岛素分泌,这与胰岛素绝对缺乏有关:随着抗精神病药物使用的不断增加,了解其风险和机制对临床医生做出明智的治疗决定和预防可能危及生命的并发症至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diabetic Ketoacidosis Associated With Second Generation Antipsychotics: A Case Study and Review of Literature.

Objective: Second-generation antipsychotics (SGAs) have revolutionized the treatment of psychiatric disorders, but are associated with significant metabolic risks, including diabetes and hyperglycemic crises. This review explores the complex interplay between antipsychotics, diabetes, and hyperglycemic crises, highlighting the mechanisms underlying SGA-induced diabetes.

Methods: We present the case of a patient with schizophrenia who was taking antipsychotic medication and was admitted to the emergency room due to the sudden onset of diabetic ketoacidosis (DKA) without any history of diabetes. We extensively searched databases, including Elsevier, PubMed, IEEE, SpringerLink, and Google Scholar, for papers on the effects of antipsychotic drugs on DKA from 2002 to 2021. We focused on DKA, hyperglycemia, and atypical antipsychotics, and retrieved 117 papers. After full-text review, 32 papers were included in this comprehensive review.

Results: DKA was significantly more frequent in patients taking SGAs. Antipsychotics can induce insulin resistance either directly or through the onset of obesity. Antipsychotics can reduce insulin secretion from pancreatic β-cells, which is associated with absolute insulin deficiency.

Conclusion: As the use of antipsychotics continues to increase, understanding their risks and mechanisms is crucial for clinicians to enable informed treatment decisions and prevent potentially life-threatening complications.

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来源期刊
CiteScore
4.10
自引率
3.70%
发文量
105
审稿时长
6-12 weeks
期刊介绍: The Psychiatry Investigation is published on the 25th day of every month in English by the Korean Neuropsychiatric Association (KNPA). The Journal covers the whole range of psychiatry and neuroscience. Both basic and clinical contributions are encouraged from all disciplines and research areas relevant to the pathophysiology and management of neuropsychiatric disorders and symptoms, as well as researches related to cross cultural psychiatry and ethnic issues in psychiatry. The Journal publishes editorials, review articles, original articles, brief reports, viewpoints and correspondences. All research articles are peer reviewed. Contributions are accepted for publication on the condition that their substance has not been published or submitted for publication elsewhere. Authors submitting papers to the Journal (serially or otherwise) with a common theme or using data derived from the same sample (or a subset thereof) must send details of all relevant previous publications and simultaneous submissions. The Journal is not responsible for statements made by contributors. Material in the Journal does not necessarily reflect the views of the Editor or of the KNPA. Manuscripts accepted for publication are copy-edited to improve readability and to ensure conformity with house style.
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