Всемирная психиатрия. №1 2020

Добавление метформина vs смена антипсихотика vs продолжение лечения антипсихотиком вместе с обучением здоровому образу жизни у молодых людей с избыточной массой тела или ожирением с тяжелыми психическими расстройствами: результаты исследования IMPACT

Christoph U. Correll1-3, Linmarie Sikich4, Gloria Reeves5, Jacqueline Johnson6, Courtney Keeton7, Marina Spanos4, Sandeep Kapoor1-3, Kristin Bussell5, Leslie Miller7, Tara Chandrasekhar4, Eva M. Sheridan8, Sara Pirmohamed5, Shauna P. Reinblatt5,7, Cheryl Alderman9, Abigail Scheer4, Irmgard Borner1, Terrence C. Bethea4,10, Sarah Edwards5, Robert M. Hamer11, Mark A. Riddle7

1Division of Psychiatric Research, Zucker Hillside Hospital, NY, USA; 2Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; 3Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany; 4Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; 5Division of Child and Adolescent Psychiatry, School of Medicine, University of Maryland, Baltimore, MD, USA; 6SAS Institute, Cary, NC, USA; 7Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA; 8Department of Science Education, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; 9Duke Clinical Research Institute, Durham, NC, USA; 10Hughes Center, Danville, VA, USA; 11Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA

Стр. 69-79

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Опубликовано: 12 февраля 2020

Аннотация / Abstract

a:2:{s:4:"TEXT";s:65528:"a:2:{s:4:"TYPE";s:4:"HTML";s:4:"TEXT";s:70861:"Перевод: Шишорин Р.М. (Москва) Редактура: к.м.н. Федотов И.А. (Рязань) Резюме Антипсихотики используются при многих психических состояниях у молодежи. Хоть и несоответствующий развитию набор веса и метаболические нарушения, которые являются факторами риска для преждевременной сердечно-сосудистой смертности, особенно часто встречаются у молодежи, оптимальные стратегии по уменьшению антипсихотик-индуцированного набора веса и ожирения остаются неясными. Исследование улучшения метаболических параметров при лечении антипсихотиками детей (Improving Metabolic Parameters in Antipsychotic Child Treatment (IMPACT)) было рандомизированным, с параллельными группами, 24-недельным клиническим исследованием, которое включало психически стабильных молодых людей с избыточной массой тела/ожирением, в возрасте 8–19 лет с тяжелым психическим расстройством, диагностированным по DSM-IV (расстройство шизофренического спектра, расстройство биполярного спектра или психотическая депрессия) в четырех университетах США. У всех из них произошел значительный набор веса в ходе лечения антипсихотиками второго поколения. Централизованная компьютерная система рандомизации распределила участников по открытым группам лечения: метформин (MET); смена антипсихотика (арипипразол или, в случае его применения, перфеназин или молиндон, SWITCH); или продолжение базового антипсихотика (CONTROL). Все участники проходили обучение здоровому образу жизни. Первичным клиническим результатом было изменение стандартной оценки (z-score) индекса массы тела (ИМТ) от исходных значений, проанализированное с использованием вычисленных среднеквадратичных средних значений. В целом было рандомизировано 127 участников: 49 в группу MET, 31 в группу SWITCH, и 47 в группу CONTROL. Стандартная оценка ИМТ значимо уменьшилась в группах MET (24 неделя: -0,09±0,03, p=0,002) и SWITCH (24 неделя: -0,11±0,04, р=0,003), в то время как незначимо увеличилась ...

Перевод: Шишорин Р.М. (Москва) Редактура: к.м.н. Федотов И.А. (Рязань) Резюме Антипсихотики используются при многих психических состояниях у молодежи. Хоть и несоответствующий развитию набор веса и метаболические нарушения, которые являются факторами риска для преждевременной сердечно-сосудистой смертности, особенно часто встречаются у молодежи, оптимальные стратегии по уменьшению антипсихотик-индуцированного набора веса и ожирения остаются неясными. Исследование улучшения метаболических параметров при лечении антипсихотиками детей (Improving Metabolic Parameters in Antipsychotic Child Treatment (IMPACT)) было рандомизированным, с параллельными группами, 24-недельным клиническим исследованием, которое включало психически стабильных молодых людей с избыточной массой тела/ожирением, в возрасте 8–19 лет с тяжелым психическим расстр...

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