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Consortium Psychiatricum
2022. Том 3. № 1. С. 45–61
doi:10.17816/CP105
ISSN: 2712-7672 / 2713-2919 (online)

Симптоматический профиль карипразина в контексте доменов шизофрении в МКБ-11: обзор клинически ориентированных исследований

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Павличенко А.В., Губина А.С.

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Аннотация

ВВЕДЕНИЕ: Одним из нововведений раздела МКБ-11 «шизофрения и другие первичные психотические расстройства» является имплементация 6 дополнительных доменов, которые должны улучшить диагностику и лечение данных состояний в клинической практике. В связи с этим, актуальной задачей является оценка влияния различных психотропных средств, в первую очередь, антипсихотиков, на выделенные домены психотических расстройств. В данном обзоре в качестве психотропного средства был выбран антипсихотик карипразин, который зарегистрирован во многих странах мира, включая Россию, для лечения шизофрении, который зарегистрирован для лечения шизофрении во многих странах мира, включая Россию.

МЕТОДЫ: Для данного обзора был осуществлен поиск рандомизированных контролируемых исследований, сравнивающих карипразин с плацебо, с одним или несколькими антипсихотиками. Поиск произведен по базам данных MEDLINE, Cochrane Central Register of Controlled Trials и PubMed. Глубина поиска с января 2014 по март 2021 года.

РЕЗУЛЬТАТЫ: Результаты свидетельствуют о том, что карипразин эффективен в отношении всех групп симптомов домена МКБ-11 «позитивные симптомы» и может рассматриваться как препарат выбора при лечении первых и множественных эпизодов болезни, дезорганизации мышления и нарушенного поведения в виде агрессии и враждебности. Карипразин имеет наилучшую среди всех антипсихотиков доказательную базу для лечения разных симптомов домена МКБ-11 «негативные симптомы». Данные о влиянии карипразина на домен «депрессивные симптомы» являются противоречивыми. Отсутствуют данные о влиянии карипразина на домен «маниакальные симптомы», но доказана эффективность монотерапии карипразином маниакальных эпизодов без признаков психомоторного возбуждения при биполярном расстройстве. Исследования эффективности терапии карипразином домена МКБ-11 «психомоторные симптомы» не проводилось ни в рамках монотерапии, ни в рамках адьювантной терапии. Карипразин доказал эффективность в лечении домена «когнитивные симптомы» и прокогнитивный эффект препарата развивался независимо от его влияния на другие симптомы шизофрении. Была показана возможность препарата улучшать функционирования больных шизофренией, независимо от влияния на симптомы заболевания.

ВЫВОДЫ: Карипразин является препаратом первого выбора при лечении домена «негативные симптомы», а также препаратом выбора при лечении доменов МКБ-11 «позитивные симптомы» и «когнитивные симптомы». Необходимы дополнительные исследования для оценки влияния карипразина на домены МКБ-11 «маниакальные симптомы» и «депрессивные симптомы».

Общая информация

Ключевые слова: шизофрения, МКБ-11, психические расстройства

Рубрика издания: Обзоры

Тип материала: обзорная статья

DOI: https://doi.org/10.17816/CP105

Получена: 16.08.2021

Принята в печать:

Для цитаты: Павличенко А.В., Губина А.С. Симптоматический профиль карипразина в контексте доменов шизофрении в МКБ-11: обзор клинически ориентированных исследований // Consortium Psychiatricum. 2022. Том 3. № 1. С. 45–61. DOI: 10.17816/CP105

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Информация об авторах

Павличенко Алексей Викторович, кандидат медицинских наук, Старший преподаватель Образовательного центра , ГБУЗ «Психиатрическая клиническая больница № 1 им. Н.А. Алексеева Департамента здравоохранения города Москвы», Россия, ORCID: https://orcid.org/0000-0003-2742-552X

Губина Анна Сергеевна, врач психиатр, ГБУЗ «Психиатрическая клиническая больница № 1 им. Н.А. Алексеева Департамента здравоохранения города Москвы», Москва, Россия

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