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阿立哌唑Abilify

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阿立哌唑Abilify
药品名称:阿立哌唑Abilify
药品别名:Aripiprazole,安律凡
英 文 名:Aripiprazole
药品价格:$ 美国市场售价 31.73 美元
研发公司:
适 用 症:用于治疗各类型的精神分裂症。
型号规格:本品为5mg/15片,10mg/30片两种规格
药品详情:

阿立哌唑Abilify 适应症】
 
    阿立哌唑Abilify(又名Aripiprazole,安律凡)用于治疗各类型的精神分裂症。国外临床试验表明,本品对精神分裂症的阳性和阴性症状均有明显疗效,也能改善伴发的情感症状,降低精神分裂症的复发率。

阿立哌唑Abilify_香港济民药业

阿立哌唑Abilify_香港济民药业

 
【阿立哌唑Abilify 规格】
 
    本品为5mg/15片,10mg/30片两种规格。
 
【阿立哌唑Abilify 服用方法】
 
    因剂型和对应的症状不同,用法用量请遵从医师指导。
 
【阿立哌唑Abilify 注意事项】
 
①慎用于心血管疾病患者(心肌梗死、缺血性心脏病、心脏衰竭或者传导异常病史)、脑血管疾病患者或者诱发低血压的情况(如:脱水、血容量过低和降压药治疗)。
 
②慎用于有癫痫病史或癫痫阈值较低的情况。
 
③慎用于有吸入性肺炎风险性的患者。
 
阿立哌唑Abilify 不良反应】
 
    比较轻,体重增加、锥体外系反应等发生率低,所以患者的耐受性比较好。不良反应主要有头痛,焦虑失眠,嗜睡,小便失禁,静坐不能等。


Abilify(Aripiprazole)
 
 
Aripiprazole, sold under the brand name Abilify among others, is an atypical antipsychotic.[4] It is primarily used in the treatment of schizophrenia and bipolar disorder.[4] Other uses include as an add-on treatment in major depressive disorder, tic disorders, and irritability associated with autism.[4] A Cochrane review found evidence in schizophrenia not sufficient to determine effects on general functioning.[5]Additionally, as many people dropped out of the studies before they were completed, the strength of the conclusions was low.[5] It is taken by mouth or injection into a muscle.[4] 
 
Common side effects include vomiting, constipation, sleepiness, dizziness, weight gain, and movement disorders.[4] Serious side effects may include neuroleptic malignant syndrome, tardive dyskinesia, and anaphylaxis.[4] It is not recommended for older people with dementia-related psychosis due to an increased risk of death.[4] In pregnancy there is possible evidence of harm to the baby.[4][6] It is not recommended in women who are breastfeeding.[4]It has not been very well studied in people less than 18 years old.[4] How it works is not entirely clear, but may involve effects on dopamine and serotonin.[4] 
 
Aripiprazole was approved for medical use in the United States in 2002.[4] It is available as a generic medication.[7] In the United Kingdom a months supply costs the NHS about 2.75 pounds as of 2019.[7] In the United States the wholesale cost of this amount is 10 USD.[8] In 2016 it was the 131st most prescribed medication in the United States with more than 5 million prescriptions.[9] Aripiprazole was discovered by scientists at Otsuka Pharmaceutical.[10]
 
Medical uses
 
Aripiprazole is primarily used for the treatment of schizophrenia or bipolar disorder.[4][11][12]
Schizophrenia
The 2016 NICE guidance for treating psychosis and schizophrenia in children and young people recommended aripiprazole as a second line treatment after risperidone for people between 15 and 17 who are having an acute exacerbation or recurrence of psychosis or schizophrenia.[13] A 2014 NICE review of the depot formulation of the drug found that it might have a role in treatment as an alternative to other depot formulations of second generation antipyschotics for people who have trouble taking medication as directed or who prefer it.[14]
 
A 2014 Cochrane review comparing aripiprazole and other atypicals, found that it is difficult to determine differences as data quality is poor.[15] A 2011 Cochrane review comparing aripiprazole with placebo concluded that high dropout rates in clinical trials, and a lack of outcome data regarding general functioning, behavior, mortality, economic outcomes, or cognitive functioning make it difficult to definitively conclude that aripiprazole is useful for the prevention of relapse.[5]
 
A 2013 Lancet review found that it is in the middle range of 15 antipsychotics for effectiveness, approximately as effective as haloperidol and quetiapine and slightly more effective than ziprasidone, chlorpromazine, and asenapine, with better tolerability compared to the other antipsychotic drugs (4th best for weight gain, 5th best for extrapyramidal symptoms, best for prolactin elevation, 2nd best for QTc prolongation, and 5th best for sedation). The authors concluded that for acute psychotic episodes aripiprazole results in benefits in some aspects of the condition.[16]
 
In 2013 the World Federation of Societies for Biological Psychiatry recommended aripiprazole for the treatment of acute exacerbations of schizophrenia as a Grade 1 recommendation and evidence level A.[17]
 
The British Association for Psychopharmacology similarly recommends that all persons presenting with psychosis receive treatment with an antipsychotic, and that such treatment should continue for at least 1–2 years, as "There is no doubt that antipsychotic discontinuation is strongly associated with relapse during this period". The guideline further notes that "Established schizophrenia requires continued maintenance with doses of antipsychotic medication within the recommended range (Evidence level A)".[18]
 
The British Association for Psychopharmacology[18] and the World Federation of Societies for Biological Psychiatry suggest that there is little difference in effectiveness between antipsychotics in prevention of relapse, and recommend that the specific choice of antipsychotic be chosen based on persons preference and side effect profile. The latter group recommends switching to aripiprazole when excessive weight gain is encountered during treatment with other antipsychotics.[17]
Bipolar disorder
Aripiprazole is effective for the treatment of acute manic episodes of bipolar disorder in adults, children, and adolescents.[19][20] Used as maintenance therapy, it is useful for the prevention of manic episodes, but is not useful for bipolar depression.[21][22] Thus, it is often used in combination with an additional mood stabilizer; however, co-administration with a mood stabilizer increases the risk of extrapyramidal side effects.[23]
Major depression
Aripiprazole is an effective add-on treatment for major depressive disorder; however, there is a greater rate of side effects such as weight gain and movement disorders.[24][25][26][27]The overall benefit is small to moderate and its use appears to neither improve quality of lifenor functioning.[25] Aripiprazole may interact with some antidepressants, especially SSRIs. There are interactions with fluoxetine and paroxetine and lesser interactions with sertraline, escitalopram, citalopram and fluvoxamine, which inhibit CYP2D6, for which aripiprazole is a substrate. CYP2D6 inhibitors increase aripiprazole concentrations to 2-3 times their normal level.[28]
Autism
Short-term data (8 weeks) shows reduced irritability, hyperactivity, inappropriate speech, and stereotypy, but no change in lethargic behaviours.[29] Adverse effects include weight gain, sleepiness, drooling and tremors.[29] It is suggested that children and adolescents need to be monitored regularly while taking this medication, to evaluate if this treatment option is still effective after long-term use and note if side effects are worsening. Further studies are needed to understand if this drug is helpful for children after long term use.[29]
Obsessive–compulsive disorder
A 2014 systematic review concluded that add-on therapy with low dose aripiprazole is an effective treatment for obsessive-compulsive disorderthat does not improve with SSRIs alone. The conclusion was based on the results of two relatively small, short-term trials, each of which demonstrated improvements in symptoms.[30] Risperidone (another second-generation antipsychotic) appears to be superior to aripiprazole for this indication, and is recommended by the 2007 American Psychiatric Association guidelines, though aripiprazole is cautiously recommended by a 2017 review by Pignon and colleagues.[31]
 
Adverse effects
 
In adults side effects with greater than 10% incidence include weight gain, headache, agitation or anxiety, insomnia, and gastro-intestinal effects like nausea and constipation, and lightheadedness.[28][1][2][3][32] Side effects in children are similar, and include sleepiness, increased appetite, and stuffy nose.[28] A strong desire to gamble, binge eat, shop, and have sex may also occur.[33][34]
Uncontrolled movement such as restlessness, tremors, and muscle stiffness may occur.[28]
Discontinuation
The British National Formulary recommends a gradual withdrawal when discontinuing anti-psychotic treatment to avoid acute withdrawal syndrome or rapid relapse.[35] Joanne Moncrieff has suggested that the withdrawal process might itself be schizo-mimetic, producing schizophrenia-like symptoms even in previously healthy people, indicating a possible pharmacological origin of mental illness in a yet unknown percentage of people currently and previously treated with antipsychotics, but limited evidence was found to support this hypothesis for antipsychotics other than clozapine.[36]
 
Overdose
 
Children or adults who ingested acute overdoses have usually manifested central nervous system depression ranging from mild sedation to coma; serum concentrations of aripiprazole and dehydroaripiprazole in these people were elevated by up to 3-4 fold over normal therapeutic levels; as of 2008 no deaths had been recorded.[37][38]
 
 




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