Амисульприд с позиции эффективности и безопасности

   Представлены результаты клинических исследований применения амисульприда при шизофрении.

   Цель работы — анализ применения амисульприда при различных формах шизофрении с позиции эффективности и безопасности применения на основании результатов проведённых клинических исследований, опубликованных в научной литературе.

   Амисульприд — атипичный антипсихотик, отличающийся уникальным рецепторным профилем и рядом необычных фармакологических свойств от других известных атипичных антипсихотиков (в частности, он является парциальным 5 HT4-агонистом, парциальным агонистом GHB рецепторов, мощным антагонистом 5 HT7-рецепторов). Он обладает антидепрессивной, анксиолитической, анальгетической и противорвотной активностью, имеет малую вероятность возникновения экстрапирамидных нежелательных явлений и проявляет высокую эффективность в устранении негативной симптоматики, когнитивных и депрессивных нарушений при шизофрении и других психозах. Имеются данные об эффективности амисульприда в отношении агрессивности, враждебности, симптомов тревоги, часто наблюдающихся при острой экзацербации шизофренического психоза, а также при аффективных расстройствах (большой депрессивный эпизод, дистимия, мания). Амисульприд также продемонстрировал эффективность при резистентности к другим антипсихотикам. При комбинированном применении с клозапином он не только усиливает антипсихотическое действие клозапина, но и уменьшает гиперсаливацию, вызываемую клозапином. Согласно результатам представленных клинических исследований, назначение амисульприда оказывает положительное действие как на позитивную симптоматику, так и на негативные проявления шизофрении. Профиль безопасности амисульприда уникален в сравнении как с классическими, так и атипичными антипсихотиками. Малая степень биотрансформации, отсутствие активных метаболитов и преимущественная почечная экскреция делают возможным назначение препарата даже пациентам с нарушением функций печени и пожилым больным. Амисульприд не вступает во взаимодействие с какими-либо лекарственными препаратами, что также является большим преимуществом препарата. В ряде работ сообщается, что при приёме амисульприда в дозе до 800 мг практически не фиксируется экстрапирамидных нарушений. В отличие от большинства атипичных антипсихотиков у амисульприда способность вызывать прибавку массы тела минимальна.

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