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Механизмы развития антипсихотик-индуцированных метаболических нарушений: фармакогенетический аспект

https://doi.org/10.20538/1682-0363-2017-4-30-41

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Аннотация

Антипсихотики являются основными лекарственными препаратами в терапии расстройств шизофренического спектра. Антипсихотические препараты требуют длительного применения, обладают узкой терапевтической широтой, большим спектром и выраженностью нежелательных лекарственных реакций, проявление которых во многом определяется генотипом пациента. Выраженность нежелательных лекарственных реакций у препаратов первой и второй генераций антипсихотиков различна.

Применение атипичных антипсихотиков, в отличие от типичных, реже вызывает экстрапирамидные расстройства, но индуцирует, прежде всего, метаболические нарушения: изменение веса, дизрегуляцию метаболизма глюкозы, дислипидемию. Перечисленные нежелательные лекарственные реакции в значительной мере снижают приверженность пациентов к терапии и могут привести к серьезным осложнениям в дальнейшем. Клинический опыт применения антипсихотиков показал, что выраженность нежелательных реакций одного препарата, принимаемого различными пациентами, является вариабельным показателем в связи с полиморфизмом генов фармакокинетических и фармакодинамических факторов, задействованных в реализации фармакологического действия антипсихотиков. В связи с этим изучение влияния различных комбинаций полиморфных вариантов генов фармакокинетических и фармакодинамических факторов на развитие антипсихотик-индуцированных метаболических нарушений является приоритетной задачей персонализированной психиатрии. 

Об авторах

Р. Ф. Насырова
Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. Бехтерева
Россия

д-р мед. наук, вед. науч. сотрудник, руководитель

отделение персонализированной психиатрии и неврологии

192019, г. Санкт-Петербург, ул. Бехтерева, 3/1 



М. Ю. Толмачев
Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. Бехтерева
Россия

мл. науч. сотрудник

отделение персонализированной психиатрии и неврологии

192019, г. Санкт-Петербург, ул. Бехтерева, 3/1 



Д. А. Сычев
Российская медицинская академия непрерывного профессионального образования
Россия

д-р мед. наук, профессор, член-корр. РАН, зав. кафедрой

кафедра клинической фармакологии и терапии

125993, г. Москва, ул. Баррикадная, 2/1/1 



К. К. Яхин
Казанский государственный медицинский университет
Россия

д-р мед. наук, профессор, зав. кафедрой

кафедра психиатрии с курсом наркологии

420012, г. Казань, ул. Бутлерова, 49



Н. Г. Незнанов
Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. Бехтерева
Россия

д-р мед. наук, профессор, директор

192019, г. Санкт-Петербург, ул. Бехтерева, 3/1 



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Для цитирования:


Насырова Р.Ф., Толмачев М.Ю., Сычев Д.А., Яхин К.К., Незнанов Н.Г. Механизмы развития антипсихотик-индуцированных метаболических нарушений: фармакогенетический аспект. Бюллетень сибирской медицины. 2017;16(4):30-41. https://doi.org/10.20538/1682-0363-2017-4-30-41

For citation:


Nasyrova R.F., Tolmachev M.Y., Sychev D.A., Yakhin K.K., Neznanov N.G. Mechanisms of development of antipsychotic-induced metabolic disorders: pharmacogenetic aspect. Bulletin of Siberian Medicine. 2017;16(4):30-41. (In Russ.) https://doi.org/10.20538/1682-0363-2017-4-30-41

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ISSN 1682-0363 (Print)
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