Sertindole:新药。另一个“非典型”安定;QT延长。

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Sertindole:新药。另一个“非典型”安定;QT延长。

Prescrire Int。2007年4月16日(88年):59 - 62。

PubMed ID

17458045 (在PubMed

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文摘

(1)一线药物治疗精神分裂症疾病是一个安定如氟哌啶醇。Amisulpride时可能会比氟哌啶醇会导致不可接受的神经反应。总的来说,最近的风险收益平衡,所谓的非典型抗精神病也好不到哪儿去。(2)Sertindole,安定,在欧洲多个国家在1996年首次上市之前撤回两年后因为众多心脏副作用。它再一次被批准,应该很快可以在法国市场。(3)两个比较双盲试验表明,每日sertindole 24毫克的剂量是有效的10毫克氟哌啶醇。Sertindole没有更有效的比利培酮试验比较这两种药物。(4)像其他“非典型”精神安定剂,sertindole几乎没有短期神经副作用(锥体外系综合征)在临床试验中使用的剂量。然而,它会导致体重增加。Sertindole也有α阻塞特性,可引起体位性低血压引起射精量减少; it also has atropinic effects (constipation, dry mouth, etc.). (5) Sertindole provokes a dose-dependent increase in the QT interval more frequently than haloperidol in comparative trials, and apparently more frequently than other 'atypical' neuroleptics such as risperidone and olanzapine. Sertindole has been suspected of increasing cardiovascular mortality but this has not been established. (6) Sertindole is metabolised by cytochrome P450 isoenzymes CYP 2D6 and CYP 3A4, hence a high risk of pharmacokinetic interactions. (7) In practice, when haloperidol has to be withdrawn because of adverse effects, especially neurological reactions, it is better to continue to resort to amisulpride, for example, with close monitoring of adverse effects, rather than expose patients to the potential dangers of sertindole.

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药物

Sertindole