Sex differences in effectiveness and adverse effects of mood stabilizers and antipsychotics: A systematic review.

Autor: Ercis M; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA; Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey., Sanchez-Ruiz JA; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA., Webb LM; Department of Neurology, Mayo Clinic, Rochester, MN, USA., Solares-Bravo M; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA., Betcher HK; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA., Moore KM; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA., Frye MA; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA., Veldic M; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA., Ozerdem A; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA. Electronic address: Ozerdem.Aysegul@mayo.edu.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2024 May 01; Vol. 352, pp. 171-192. Date of Electronic Publication: 2024 Feb 15.
DOI: 10.1016/j.jad.2024.02.038
Abstrakt: Background: Psychiatric disorders differ in their prevalence, symptom profiles, and disease courses in men and women. However, sex differences in psychiatric disorders have not received enough attention to guide treatment recommendations. This systematic review aims to summarize sex differences in the treatment responses and adverse effects of mood stabilizers and antipsychotics transdiagnostically.
Methods: We conducted a systematic review following the PRISMA 2020 statement (CRD42020212478). A literature search was conducted using MEDLINE, Embase, Cochrane Central, PsycINFO, Web of Science Core Collection, and Scopus databases. Studies comparing mood stabilizer or antipsychotic treatment outcomes in men and women were included. JBI critical appraisal checklists were used to assess bias risk.
Results: Out of 4866 records, 129 reports (14 on mood stabilizers, 115 on antipsychotics) with varying designs were included. Sample sizes ranged from 17 to 22,774 participants (median = 147). The most common psychiatric diagnoses were schizophrenia spectrum (n = 109, 84.5 %) and bipolar disorders (n = 38, 29.5 %). Only four studies explored sex differences in mood stabilizer treatment response. In 40 articles on antipsychotic treatment response, 18 indicated no sex difference, while 16 showed females had better outcomes. Women had more adverse effects with both mood stabilizers and antipsychotics. The risk of bias was low in 84 (65.1 %) of studies.
Limitations: Substantial heterogeneity among the studies precluded performing a meta-analysis.
Conclusion: Number of studies focusing on sex differences in treatment outcomes of mood stabilizers is limited. Women may respond better to antipsychotics than men, but also experience more side effects. The impact of pharmacokinetics on sex differences warrants more attention.
Competing Interests: Declaration of competing interest ME's spouse is an employee of Sanofi. MAF has received grant support from Assurex Health and Mayo Foundation, received CME travel and honoraria from Carnot Laboratories and American Physician Institute, and has Financial Interest / Stock ownership / Royalties from Chymia LLC. All other authors report no financial relationships with commercial interests.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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