비정형적 항정신병제제

3. 의료 용도

비정형적 항정신병제제는 주로 조현병이나 양극성 장애 치료에 사용된다.^[6] 치매, 불안 장애, 자폐 스펙트럼 장애, 피해 망상, 강박 장애와 관련된 정신 운동성 초조 치료에도 사용될 수 있지만, 이는 허가 외 사용이다.^[7][8] 치매의 경우, 다른 치료법이 효과가 없고 환자가 자신이나 타인에게 위협이 될 때만 사용해야 한다.^[9]

3. 1. 조현병

3. 2. 양극성 장애

3. 3. 주요 우울 장애

3. 4. 자폐 스펙트럼 장애

3. 5. 치매 및 알츠하이머병

4. 부작용

비정형 항정신병제는 다양한 부작용을 유발할 수 있으며, 약물마다 그 특성이 다르다.^[2] 일반적으로 전형적인 항정신병제보다 지연성 운동 이상증 발생 가능성이 낮다고 알려져 있지만, 장기간 사용 시에는 여전히 발생할 수 있다.^[2][52]

주요 부작용으로는 심혈관 질환 위험 증가^[53], 성 기능 장애 (성적 관심 감소, 사정 실패, 월경 불순, 불임, 유방 비대, 유루증 등)^[54][111], 프로락틴 수치 증가 (특히 설피리드, 아미설프라이드, 리스페리돈, 팔리페리돈 등)^[111], 체중 증가, 고혈당증, 당뇨병 등의 대사 부작용^[64]이 있다. 일부 비정형 항정신병제는 약물 유발 강박 장애를 유발할 수 있다는 보고도 있다.^{[58][59][60][61]}

미국 식품의약국(FDA)은 치매 환자에게 비정형 항정신병제를 사용할 경우 뇌졸중 위험 증가 및 사망률 증가를 경고했다.^[55][56]

비정형 항정신병 약물의 금단 증상으로는 메스꺼움, 구토, 식욕 부진, 안절부절못함, 땀 과다, 수면 장애 등이 있으며, 약물 중단 시 정신병이 재발할 수 있다.^[79][80][81]

4. 1. 부작용 비교표

5. 사회와 문화

2007년 5월부터 2008년 4월까지 미국에서 550만 명이 비정형 항정신병 약물을 처방받았다.^[136] 65세 미만 환자의 71%가 정신분열증 또는 양극성 장애 치료를 위해 처방받았지만, 65세 이상 환자에서는 이 비율이 38%로 감소했다.^[136] 이는 비정형 항정신병 약물이 정신병 외 다른 질환에도 사용됨을 시사한다.

"항정신병 약물"이라는 명칭과 달리, 이 약물은 정신병과 관련 없는 다양한 질환에 사용되는 경우가 많다. 일부 의료 전문가는 양극성 장애 환자에게 처방 시 "비정형 항정신병 약물"이라는 용어를 사용하지 않는다고 밝혔다.^[137]

5. 1. 규제 현황

5. 2. 소송

6. 한국에서의 사용 및 논란

한국에서는 비정형 항정신병제가 정신 질환 치료뿐만 아니라, 노인 치매 환자의 문제 행동, 수면 장애, 섬망 등 다양한 증상에 사용되고 있다. 특히 요양 시설 등에서 노인 환자에게 과도하게 처방되는 경우가 많아 오남용 문제가 제기되고 있다. 더불어민주당 등 정치권에서는 비정형 항정신병 약물 오남용 문제 해결을 위한 정책 마련에 관심을 기울이고 있다. 건강보험심사평가원 자료에 따르면, 한국의 65세 이상 노인 인구 중 비정형 항정신병제 처방률은 OECD 평균보다 높게 나타났다.^[82]

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