呼吸衰竭与精神药物之间的关系:系统回顾

IF 3.7 2区 医学 Q1 PSYCHIATRY
Sara Winter , Kyung Rok Lee , Edward Fung , Tara Kirkpatrick , Karl Winckel , Timothy Tanzer , Nicola Warren , Dan Siskind , Claire Michelle Ellender
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引用次数: 0

摘要

方法 对 Embase、PubMed、CINAHL、PsycINFO 和 Cochrane 试验登记数据库中评估慢性精神疾病患者呼吸衰竭与精神药物使用之间关系的出版物进行系统检索。在抗抑郁药研究中,没有关于抗抑郁药的使用与呼吸衰竭之间关系的报道,但这些研究中都没有报告正式的几率比。三项抗精神病药物研究符合纳入标准,共纳入 169,919 名参与者。不过,其中两项研究来自重叠的数据集,其中一项研究以摘要形式报道。没有一项研究对吸烟状况这一关键混杂因素进行了控制。所有三项研究都表明,使用抗精神病药物会增加呼吸衰竭的风险(调整后的几率范围为 1.13 95% CI:1.2-1.89;至 2.33 95% CI:2.06-2.64)。在三项抗精神病药物研究中,有两项研究的偏倚风险较低。三项关于抗精神病药物与呼吸衰竭的研究表明呼吸衰竭的风险增加。然而,这些研究显示出明显的异质性和混杂因素(如吸烟状况),并且缺乏应对这些因素的策略。有两项研究来自重叠的数据集,一项研究为摘要。鉴于抗精神病药物会增加呼吸衰竭的风险,因此需要通过大型匹配和独立的数据集来进一步报告这种关联,以便进行荟萃分析,量化这种风险增加的性质和程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The association between respiratory failure and psychotropic medications: A systematic review

Objective

To examine the association between psychotropic medication usage and respiratory failure.

Methods

A systematic search of Embase, PubMed, CINAHL, PsycINFO, and the Cochrane Trial Registry databases for publications that evaluated the association between respiratory failure and the use of psychotropic medications in patients with chronic mental health disorders was performed.

Results

Nine studies were included, with a total of 170,435 participants. There was no association between antidepressant use and respiratory failure reported in the antidepressant studies, however no formal odds ratio was reported in any of these studies. Three antipsychotic studies met inclusion criteria, which included a total of 169,919 participants. However, two of these studies were derived from overlapping datasets, and one of these studies was reported as an abstract. None controlled for the key confounder of smoking status. All three demonstrated an increased risk of respiratory failure with antipsychotic use (adjusted odds ratio ranged from 1.13 95% CI: 1.2–1.89; to 2.33 95% CI: 2.06–2.64). Two out of three antipsychotic studies had a low risk of bias.

Conclusions

No clear association between antidepressants and respiratory failure was identified. Three studies examining antipsychotic medications and respiratory failure indicated an increased risk for respiratory failure. However, studies demonstrated significant heterogeneity and confounding factors (e.g. smoking status) and strategies to deal with these were absent. Two studies were derived from overlapping datasets and one study was an abstract. Given the signal towards increased risk of respiratory failure with antipsychotic medications, further reporting on this association through large matched and independent datasets is required to allow meta-analysis to quantify the nature and extent of this increased risk.
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来源期刊
Journal of psychiatric research
Journal of psychiatric research 医学-精神病学
CiteScore
7.30
自引率
2.10%
发文量
622
审稿时长
130 days
期刊介绍: Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;
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