富马酸喹硫平片联合使用丙戊酸钠缓释片(I) 致血糖升高1例分析
Analysis of One Case of Hyperglycemia Induced by the Combined Use of Quetiapine Fumarate Tablets and Sodium Valproate Sustained-Release Tablets (I)
DOI: 10.12677/acm.2026.1651813, PDF,    科研立项经费支持
作者: 王李安安, 冼耀东：香港大学深圳医院中医部，广东 深圳；赵 燕, 贾竑晓*：首都医科大学附属北京安定医院中西医结合科，北京
关键词: 富马酸喹硫平片；丙戊酸钠缓释片(I)；血糖升高；不良反应；心境障碍；Quetiapine Fumarate Tablets； Sodium Valproate Sustained-Release Tablets (I)； Hyperglycemia； Adverse Reactions； Mood Disorder
摘要: 目的：报道富马酸喹硫平(后简称喹硫平)联合丙戊酸钠缓释片(I) (后简称丙戊酸钠)致血糖升高1例。方法：对于喹硫平联合丙戊酸钠致血糖升高的病例进行分析，及机制探讨，提出合理使用建议。结果与结论：喹硫平联合丙戊酸钠引起血糖升高的机理暂不明确，或与叠加使用影响下丘脑食欲调节中枢有关，但两种药物均有引起代谢综合征风险，出现糖脂代谢异常，导致胰岛素抵抗，引起血糖升高。后续用药应加强基线筛查，关注体重增长情况，并在出现血糖升高后及时对症处理或调药。
Abstract: Objective: To report a case of hyperglycemia induced by the combined use of quetiapine fumarate tablets (hereinafter referred to as quetiapine) and sodium valproate extended-release tablets (I) (hereinafter referred to as sodium valproate). Methods: The clinical case of hyperglycemia associated with quetiapine and sodium valproate coadministration was analyzed, and the underlying mechanisms were explored, with recommendations for rational clinical use provided. Results and Conclusion: The mechanism by which quetiapine combined with valproic acid sodium causes an increase in blood sugar is not yet clear. It may be related to the combined use affecting the hypothalamic appetite regulation center. However, both drugs have the risk of causing metabolic syndrome, resulting in abnormal sugar and lipid metabolism, leading to insulin resistance and causing an increase in blood sugar. Subsequent medication should strengthen baseline screening, pay attention to weight gain, and promptly provide symptomatic treatment or adjust the medication when blood sugar increases.
文章引用：王李安安, 冼耀东, 赵燕, 贾竑晓. 富马酸喹硫平片联合使用丙戊酸钠缓释片(I) 致血糖升高1例分析[J]. 临床医学进展, 2026, 16(5): 247-252. https://doi.org/10.12677/acm.2026.1651813

参考文献

[1] 庄红艳, 刘杰, 杜海霞, 等. 丙戊酸钠缓释片致喹硫平血药浓度升高例分析[J]. 中国药物警戒, 2021, 18(10): 986-988.
[2] 朱叶, 朱军, 房杨. 丙戊酸钠结合非典型抗精神病药物治疗双相情感障碍的机制及对TBIL, UA和BDNF的影响[J]. 心理月刊, 2025, 20(9): 164-166.
[3] 吴天灵, 翟盈. 丙戊酸钠联合喹硫平治疗双相障碍躁狂发作的临床效果[J]. 四川解剖学杂志, 2024, 32(4): 58-60.
[4] 王曼. 喹硫平联合丙戊酸钠治疗双相情感障碍躁狂发作的疗效及对认知功能的影响[J]. 中国实用医药, 2023, 18(9): 119-122.
[5] 魏效峰. 富马酸喹硫平联合丙戊酸钠治疗双相情感障碍躁狂相的效果及不良反应评价[J]. 大医生, 2023, 8(8): 13-15.
[6] 墨亚芳, 李运良. 丙戊酸钠缓释片联合喹硫平治疗双相情感障碍疗效观察[J]. 中国药业, 2024, 33(S1): 38-40.
[7] 王能焜, 黄焱, 谢清芳.富马酸喹硫平联合丙戊酸钠治疗双相情感障碍患者的效果及对认知功能, 炎症氧化因子的影响[J]. 国际精神病学杂志, 2024, 51(2): 465-469.
[8] Wong, K.C., Leung, P.B., Lee, B.K., Sham, P., Lui, S.S. and So, H. (2024) Long-Term Metabolic Side Effects of Second-Generation Antipsychotics in Chinese Patients with Schizophrenia: A Within-Subject Approach with Modelling of Dosage Effects. Asian Journal of Psychiatry, 100, Article 104172. [Google Scholar] [CrossRef] [PubMed]
[9] Mazereel, V., Detraux, J., Vancampfort, D., van Winkel, R. and De Hert, M. (2020) Impact of Psychotropic Medication Effects on Obesity and the Metabolic Syndrome in People with Serious Mental Illness. Frontiers in Endocrinology, 11, Article 573479. [Google Scholar] [CrossRef] [PubMed]
[10] Goldberg, J.F. (2024) Valproate and Weight Gain: A New Look at an Old Problem. The Journal of Clinical Psychiatry, 85, 23com15213.
[11] 赖明慧. 奥氮平和喹硫平治疗精神分裂症对糖脂代谢, 肝功能及心功能的影响[J]. 中国继续医学教育, 2021, 13(32): 162-165.
[12] 辛宝泉, 张燕, 王金德. 氯氮平与喹硫平对老年精神分裂症患者免疫指标和糖脂代谢的影响[J]. 中华保健医学杂志, 2021, 23(4): 395-397.
[13] Chukwu, J., Delanty, N., Webb, D. and Cavalleri, G.L. (2013) Weight Change, Genetics and Antiepileptic Drugs. Expert Review of Clinical Pharmacology, 7, 43-51. [Google Scholar] [CrossRef] [PubMed]
[14] Shnayder, N.A., Grechkina, V.V., Trefilova, V.V., Efremov, I.S., Dontceva, E.A., Narodova, E.A., et al. (2023) Valproate-Induced Metabolic Syndrome. Biomedicines, 11, Article 1499. [Google Scholar] [CrossRef] [PubMed]
[15] Zuo, S., Fries, B.E., Szafara, K. and Regal, R. (2015) Valproic Acid as a Potentiator of Metabolic Syndrome in Institutionalized Residents on Concomitant Antipsychotics: Fat Chance, or Slim to None? P & T: A Peer-Reviewed Journal for Formulary Management, 40, 126-132.
[16] Romoli, M., Mazzocchetti, P., D’Alonzo, R., Siliquini, S., Rinaldi, V.E., Verrotti, A., et al. (2019) Valproic Acid and Epilepsy: From Molecular Mechanisms to Clinical Evidences. Current Neuropharmacology, 17, 926-946. [Google Scholar] [CrossRef] [PubMed]
[17] Verrotti, A., D'Egidio, C., Mohn, A., Coppola, G. and Chiarelli, F. (2011) Weight Gain Following Treatment with Valproic Acid: Pathogenetic Mechanisms and Clinical Implications. Obesity Reviews, 12, e32-e43. [Google Scholar] [CrossRef] [PubMed]
[18] Belcastro, V., D’Egidio, C., Striano, P. and Verrotti, A. (2013) Metabolic and Endocrine Effects of Valproic Acid Chronic Treatment. Epilepsy Research, 107, 1-8. [Google Scholar] [CrossRef] [PubMed]
[19] Kapse, S., Ando, H., Fujiwara, Y., Suzuki, C., Ushijima, K., Kitamura, H., et al. (2017) Effect of a Dosing-Time on Quetiapine-Induced Acute Hyperglycemia in Mice. Journal of Pharmacological Sciences, 133, 139-145. [Google Scholar] [CrossRef] [PubMed]
[20] Beunk, L., Nijenhuis, M., Soree, B., de Boer-Veger, N.J., Buunk, A., Guchelaar, H.J., et al. (2024) Dutch Pharmacogenetics Working Group (DPWG) Guideline for the Gene-Drug Interaction between CYP2D6, CYP3A4 and CYP1A2 and Antipsychotics. European Journal of Human Genetics, 32, 278-285. [Google Scholar] [CrossRef] [PubMed]
[21] 方贻儒, 刘铁榜. 2025中国双相障碍防治指南[M]. 北京: 人民卫生出版社, 2025.
[22] Wu, W.H., Zhi, H., Feng, W.K., Jiang, L., Yang, L., et al. (2025) Clozapine Impaired Glucose-Stimulated Insulin Secretion Partly by Increasing Plasma 5-HT Levels Due to the Inhibition of OCT1-Mediated Hepatic 5-HT Uptake in Mice. Acta Pharmacologica Sinica, 46, 687-701. [Google Scholar] [CrossRef] [PubMed]
[23] Nadubinszky, G., Vonyik, G. and Székács, B. (2026) Pszichiátriai gyógyszerek által kiváltott időskori elhízás—Szövődmények, preventív és terápiás intervenciók. Orvosi Hetilap, 167, 410-418. [Google Scholar] [CrossRef] 
[24] He, M., Zhang, Q., Deng, C., Wang, H., Lian, J. and Huang, X. (2014) Hypothalamic Histamine H1 Receptor-AMPK Signaling Time-Dependently Mediates Olanzapine-Induced Hyperphagia and Weight Gain in Female Rats. Psychoneuroendocrinology, 42, 153-164. [Google Scholar] [CrossRef] [PubMed]
[25] He, M., Deng, C. and Huang, X. (2013) The Role of Hypothalamic H1 Receptor Antagonism in Antipsychotic-Induced Weight Gain. CNS Drugs, 27, 423-434. [Google Scholar] [CrossRef] [PubMed]

为你推荐