齐拉西酮与氟哌啶醇治疗精神分裂症的对照研究

目的探讨齐拉西酮与氟哌啶醇治疗精神分裂症的疗效和安全性。方法将94例符合CCMD-3诊断标准的精神分裂症患者随机分为两组,分别给予齐拉西酮和氟哌啶醇治疗8周。分别于治疗前和治疗后2、4、6、8周末采用阳性症状和阴性症状量表(PANSS)评定临床疗效,副反应量表(TESS)评定副反应。结果治疗8周后,两组疗效近似(P>0.05),齐拉西酮组和氟哌啶醇组的有效率无显著性差异;齐拉西酮组的副反应发生率低于氟哌啶醇组,但无显著性差异。氟哌啶醇组锥体外系副反应明显高于齐拉西酮组(P<0.05)。结论齐拉西酮与氟哌啶醇对精神分裂症患者的疗效相当,副作用较小。     

齐拉西酮与氟哌啶醇治疗精神分裂症随机双盲双模拟多中心对照研究

目的:评价齐拉西酮治疗精神分裂症的疗效及安全性。方法:将235例精神分裂症病人随机分为齐拉西酮组(118例)和氟哌啶醇组(117例),齐拉西酮和氟哌啶醇最低日剂量分别定为40 mg·d~(-1)和8 mg·d~(-1),最高日剂量分别限定为160 mg·d~(-1)和20 mg·d~(-1),每日分2次服用。进行为期6 wk的多中心双盲双模拟对照研究。采用阳性和阴性症状量表(PANSS)、临床总体印象量表(CGI)、不良反应量表(TESS)及有关实验室检查评价疗效和安全性。结果:治疗结束时,2组PANSS评分较入组时均显著减低(P＜0．05);PANSS减分率——齐拉西酮组为(64±s 19)%,氟哌啶醇组为(67±24)%;临床总有效率——齐拉西酮组为81．1%,氟哌啶醇组为80．2%;2组疗效差异无显著意义。不良反应的发生率2组间比较差异无显著意义,但心电图的异常率氟哌啶醇组明显高于齐拉西酮组,差异有显著意义(P＜0．05)。结论:齐拉西酮治疗精神分裂症的疗效与氟哌啶醇相似,对心电图的影响比氟哌啶醇轻而少,是一种有效、安全的抗精神病药物。     

齐拉西酮治疗首发精神分裂症85例临床调查研究

目的探讨齐拉西酮治疗首发精神分裂症的临床疗效和安全性。方法将85例符合CCMD-3精神分裂症诊断标准的首发精神分裂症患者随机分为两组,分别给予齐拉西酮及氟哌啶醇治疗8周,采用阳性与阴性症状量表(PANSS)和不良反应量表(TESS)评定临床疗效和安全性。结果齐拉西酮与氟哌啶醇治疗精神分裂症均有较好的疗效,但齐拉西酮的不良反应小。结论齐拉西酮是治疗精神分裂症的有效药物。     

齐拉西酮注射液与氟哌啶醇注射液治疗急性精神分裂症的疗效及安全性比较

目的比较齐拉西酮注射液与氟哌啶醇注射液治疗急性精神分裂症的疗效和安全性。方法将120例住院精神分裂症急性患者随机分为齐拉西酮注射液组与氟哌啶醇注射液组,各组60例,2组剂量均为≤40mg/d,疗程为7年,以阳性症状量表评价疗效、副反应量表评定不良反应。结果齐拉西酮注射液组与氟哌啶醇注射液组的总体疗效相当（P〉0.05）,但齐拉西酮组不良反应明显低于氟哌啶醇组。结论齐拉西酮注射液是一种安全、有效的抗精神病药,其不良反应少于氟哌啶醇注射液。     

盐酸齐拉西酮和氟哌啶醇对精神分裂症认知灵活性的疗效比较

目的:探讨比较盐酸齐拉西酮和氟哌啶醇对精神分裂症患者认知灵活性的疗效.方法:对50例服用齐拉西酮维持治疗与50例服用氟哌啶醇维持治疗的精神分裂症患者进行12个月随访,采用威斯康星卡片分类(WCST)和连线测验(Trailing Making)评估患者的认知灵活性.结果:维持治疗12个月末齐拉西酮组和氟哌啶醇组的WCST测验中的总分类次数、错误数、持续错误数、非持续错误数以及连线测验各指标(连线A、B时间,A、B错误数和A、B犯规数)均显著下降(P＜0.05),并且齐拉西酮组的持续错误数减分率显著高于氟哌啶醇组(P＜0.05).治疗后,两组连线测验成绩减分率差异无统计学意义(P＞0.05).结论:齐拉西酮较氟哌啶醇更有益于改善精神分裂症患者的认知灵活性.     

阿立哌唑对精神分裂症患者的疗效及对生活质量的影响

目的:比较阿立哌唑片与氟哌啶醇片治疗精神分裂症的临床疗效和不良反应,同时探讨两药对精神分裂症患者生活质量的影响.方法:随机将70例首发精神分裂症的患者分成阿立哌唑组和氟哌啶醇组,每组35例.分别于治疗前及治疗后第1、2、4和8周末评定PANSS、TESS量表,行实验室检查及心电图检查.疗效按PANSS总分减分率来评定.于入组时及第12周末用世界卫生组织编制的生活质量量表(WHOQOL-100)评定两组患者生活质量.结论:两组疗效相仿,但阿立哌唑组对阴性症状改善明显优于氟哌啶醇组,且服用方便安全,不良反应显著较少;两组比较阿立哌唑组对生活质量改善显著优于氟哌啶醇组,且患者服药依从性好.     

盐酸齐拉西酮片与氟哌啶醇片治疗精神分裂症的随机双盲对照研究

目的评价盐酸齐拉西酮与氟哌啶醇治疗精神分裂症的临床疗效及安全性。方法选择住院患者60例,采用随机双盲法将患者分配至治疗组(30例,口服盐酸齐拉西酮片)与对照组(30例,口服氟哌啶醇片),疗程6周,临床疗效用精神分裂症阳性与阴性症状评定量表(PANSS)评定,安全性用不良反应量表(TESS)评定。结果治疗结束时PANSS减分率治疗组为(60.98±24.04)%,对照组为(62.05±28.31)%,临床总有效率治疗组为80.00%,对照组为73.33%,组间疗效差异无显著性(P>0.05);不良反应发生率治疗组较对照组略少,但组间差异无显著性(P>0.05)。结论盐酸齐拉西酮片治疗精神分裂症的疗效与氟哌啶醇片相当,是一种有效、安全的抗精神病药物。     

齐拉西酮和氟哌啶醇治疗33例急性精神分裂症患者的临床疗效与安全性对比分析

目的对比观察齐拉西酮和氟哌啶醇治疗急性精神分裂症患者的临床疗效与安全性。方法选取急性精神分裂症患者33例为研究对象,设为研究组;同期选取同症患者33例为参照对象,设为对照组;对照组肌内注射氟哌啶醇,观察组口服盐酸齐拉西酮片,对比观察两组治疗前后(2、4、8周)的阳性与阴性症状量表(PANSS)评分、治疗总有效率及不良反应率。结果两组患者PANSS评分相比于治疗前均有所下降,其中研究组的下降程度高于对照组(P<0.05),研究组临床总有效率(96.96%)效果远远高于对照组(87.87%),同时研究组不良反应率明显低于对照组(P<0.05)。结论相比于氟哌啶醇,治疗急性精神分裂症疗效更为显著,安全性高,能够有效改善患者临床症状,临床应用价值高。     

齐拉西酮合并低剂量氟哌啶醇治疗精神分裂症顽固性幻听的临床疗效

目的 观察齐拉西酮合并低剂量氟哌啶醇治疗精神分裂症顽固性幻听症状的临床疗效和安全性,并探讨其作用机制。方法 符合纳入标准的60例患者随机分为观察组和对照组,每组30例,对照组单用抗精神病药齐拉西酮治疗,观察组以齐拉西酮合并低剂量氟哌啶醇进行治疗。于治疗前及治疗后2周末、4周末、8周末、12周末分别采用阳性和阴性症状量表(PANSS)、幻听量表(AHRS)治疗前后各次的减分率评定疗效,副反应量表(TESS)评定疗效及不良反应,疗程12周。结果 治疗前,观察组和对照组PANSS总分及各分量表得分、AHRS评分的组间差异均无显著性;治疗后,2组间PANSS总分及阴性量表评分、一般病理评分比较无显著性差异,但2组在阳性量表评分及AHRS评分的比较有显著性差异(P<0.01)。结论 齐拉西酮合并低剂量氟哌啶醇治疗精神分裂症顽固性幻听的效果充分显现,不良反应轻微,治疗依从性高,可作为临床治疗精神分裂症顽固性幻听的方法之一。     

氟哌啶醇与国产齐拉西酮注射液治疗精神分裂症急性激越症状的效果观察

目的探讨氟哌啶醇与国产齐拉西酮注射液治疗精神分裂症急性激越症状的效果。方法选取2015年2月至2016年2月我院收治的68例精神分裂症急性激越症状患者,根据随机原则分为对照组及观察组各34例,对照组采取氟哌啶醇治疗,观察组采取齐拉西酮治疗,分别采用阴性与阳性症状量表及锥体外系不良反应量表评价2组患者的临床疗效及不良反应发生情况。结果对照组的临床总有效率为58.82%,观察组的临床总有效率为61.76%,经χ~2检验,2组患者的临床疗效比较差异无统计学意义,P>0.05;观察组的锥体外系不良反应总发生率为14.71%,对照组的锥体外系不良反应总发生率为32.35%,经χ~2检验,观察组的锥体外系不良反应发生率明显低于对照组,P<0.05。结论与氟哌啶醇比较,采用国产齐拉西酮注射液治疗精神分裂症急性激越症状的疗效相当,且锥体外系不良反应明显降低,具有重要的临床应用价值。     

Blood levels of haloperidol and thioridazine during maintenance neuroleptic treatment of schizophrenic outpatients

Plasma and red blood cell levels of haloperidol, thioridazine, and thioridazine's main metabolite mesoridazine were measured in schizophrenic outpatients during treatment with fixed doses of haloperidol or thioridazine for several months. These drug levels were compared to those in schizophrenic inpatients treated with fixed doses of the same neuroleptics. There were large interpatient variations in plasma and red blood cell levels at a given dose for schizophrenic outpatients as well as for inpatients. The intrapatient day-to-day fluctuation was much greater in the outpatients. The mean coefficient of variation of thioridazine or mesoridazine levels was about two-fold higher in schizophrenic outpatients than in inpatients. Differences in blood sampling time or compliance in medication ingestion do not fully explain the issue. The factors accounting for the increased intrapatient variability of plasma levels of thioridazine, mesoridazine, and haloperidol in schizophrenic outpatients remain unclear.     

Effects of acute and long‐term typical or atypical neuroleptics on morphine‐induced behavioural effects in mice

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齐哌西酮与氟哌啶醇治疗精神分裂症的疗效和安全性比较

目的：验证齐哌西酮治疗精神分裂症的疗效及安全性。方法：采用随机、双盲、双模拟、平行对照研究。治疗d 1～4,试验组每日早餐后服齐哌西酮20 mg及氟哌啶醇安慰剂1片,对照组每日早餐后服氟哌啶醇2 mg及齐哌西酮安慰剂1片；治疗d 5～42,试验组每日早、晚餐后服齐哌西酮20 mg及氟哌啶醇安慰剂1片,对照组每日早、晚餐后服氟哌啶醇2 mg及齐哌西酮安慰剂1片。疗程6 wk。结果：完成6 wk治疗的精神分裂症病人共57例,其中试验组(齐哌西酮组)29例,对照组(氟哌啶醇组)28例。治疗结束时,2组PANSS和BPRS评分较入组时均显著减低(P＜0.05)；PANSS总减分率：齐哌西酮组为(66±s 28)%,氟哌啶醇组为(66±26)%；临床总有效率：齐哌西酮组66%,氟哌啶醇组71%,2组疗效差异无显著意义(P＞0.05)。2组的不良反应发生率差异无显著意义,齐哌西酮组失眠的发生率显著高于氟哌啶醇组(P＜0.05)。结论：国产齐哌西酮治疗精神分裂症有明显疗效,未见明显不良反应。     

齐拉西酮治疗精神分裂症患者的疗效及对生活质量的影响

目的比较齐拉西酮与奋乃静对精神分裂症患者的疗效及对生活质量的影响。方法对66例精神分裂症患者随机分为两组,分别使用齐拉西酮和奋乃静治疗,疗程12周。采用阳性与阴性症状量表(PANSS)评定疗效,采用治疗中出现的症状量表(TESS)评定不良反应,以生活质量综合评定问卷(GQOLT-74)评定生活质量。结果两组疗效均显著,齐拉西酮不良反应比奋乃静少,且可显著提高生活质量。结论齐拉西酮与奋乃静对分裂症疗效相当,齐拉西酮不良反应少,对提高患者生活质量的疗效明显优于奋乃静。     

齐拉西酮注射液治疗精神分裂症急性期的对照研究

目的了解齐拉西酮注射液治疗精神分裂症急性期的疗效和不良反应。方法将80例患者随机分为研究组（40例）和对照组（40例）,研究组给予齐拉西酮注射液肌肉注射治疗,对照组给予氟哌啶醇注射液肌肉注射,两组疗程均为7 d。分别于治疗前、治疗第1、3、5、7 d进行阳性和阴性症状量表（PANSS量表）评定,以PANSS量表兴奋因子条目减分率为疗效判定标准,副反应采用不良反应量表（TESS量表）评定。结果研究组有效率为85.0%;对照组有效率为80.0%。研究组有效率与对照组相比无统计学差异（2χ=0.35,P〉0.05）,研究组不良反应在锥体外系、心电图异常等方面发生率比氟哌啶醇低。结论精神分裂症急性期使用齐拉西酮注射液治疗,疗效和氟哌啶醇注射液相似,不良反应更少。     

Rimcazole (BW234U) in the maintenance treatment of outpatients with schizophrenia

Rimcazole (BW234U), a substituted carbazole compound, has been reported to be effective in treating acutely ill schizophrenic patients without significant extrapyramidal side effects. A two-phase study was done to assess the efficacy and safety of rimcazole in the maintenance treatment of schizophrenia. Study I was a double-blind comparison of rimcazole (50–300 mg daily) with haloperidol (5–30 mg daily) with ten stable schizophrenic outpatients. Three of six patients relapsed on rimcazole, while there were no relapses on haloperidol. One patient dropped out of each group. Extrapyramidal side effects were minimal in the rimcazole group, and two patients with tardive dyskinesia showed marked improvement in AIMS Scores. Study II was an open label trial of rimcazole using a higher maximum dose of 450 mg daily in seven schizophrenic outpatients. Four of the seven patients relapsed, at a mean of 7 weeks, one dropped out, and two patients remained stable. While the drug was generally well tolerated, both of the nonrelapsing patients developed transient elevations in liver transaminases. The small sample size in these studies prevents definitive conclusions to be drawn. There may be subgroups of schizophrenic patients who can be successfully maintained on rimcazole with less morbidity than from standard neuroleptic drugs.     

Extrapyramidal symptoms during treatment of first schizophrenia episode: Results from EUFEST

The European First Episode Schizophrenia Trial (EUFEST) included first-episode schizophrenia patients, assessing the efficacy of five antipsychotic drugs (haloperidol, amisulpride, olanzapine, quetiapine and ziprasidone) over one year. Baseline frequency of extrapyramidal symptoms (EPS) in this group of patients (n=490) was as follows: parkinsonism 10.8%, akathisia 10.0%, dystonia 1.8%, and dyskinesia 0.6%. The frequency of parkinsonism at baseline was greater in patients with a brief prior exposure to antipsychotics (≤2 weeks) compared with antipsychotic-naïve ones, and was positively correlated with the intensity of negative symptoms and negatively with depressive symptoms. After one month of treatment, the increase of parkinsonism was highest in patients receiving haloperidol (+13%), that of akathisia in patients treated with ziprasidone (+14%), and 10.1% of the patients were taking anticholinergic drugs, most frequently in the haloperidol group (24%). In 291 patients remaining on treatment after one year, both parkinsonism and akathisia had decreased: the frequency of parkinsonism was 3%, highest in the haloperidol group (9.1%), that of akathisia was 3%, highest in the quetiapine group (7.5%), and 4% of patients were taking anticholinergic drugs, most frequently those receiving haloperidol (10.5%). The results obtained suggest that in first-episode schizophrenia patients during the first year of antipsychotic treatment (in this case amisulpride, haloperidol in low doses, olanzapine, quetiapine and ziprasidone), EPS were present as manageable clinical problems.     

Efficacy of olanzapine and ziprasidone for the treatment of schizophrenia: a systematic review

It is difficult to determine the relative efficacy of atypical antipsychotics for the treatment of schizophrenia, based on the available literature. The purpose of this article is to review and compare the efficacy of two atypical antipsychotics: olanzapine and ziprasidone.This review focused on randomised trials in which these two antipsychotics were compared with placebo, conventional antipsychotics and each other. Common efficacy measures were the Brief Psychiatric Rating Scale, Positive and Negative Syndrome Scale and Schedule for Assessment of Negative Symptoms. When sufficient data were available, the mean treatment effect (with 95% confidence intervals) was computed and presented.Olanzapine was consistently found to be significantly superior to placebo and comparable with, or superior to, haloperidol for the treatment of overall, positive and negative schizophrenic symptoms. Ziprasidone appears to have significantly greater efficacy than placebo for overall and negative symptoms, but it remains uncertain whether ziprasidone is comparable in efficacy with conventional antipsychotics such as haloperidol. Two unpublished clinical trials have directly compared olanzapine and ziprasidone. One of these trials found no significant efficacy differences between the two drugs, whereas the results of the other study favoured olanzapine.Compared with ziprasidone, olanzapine has a larger body of evidence supporting its efficacy, and a greater proportion of findings for olanzapine have been published, allowing for greater scrutiny of results. Both drugs appear to be superior to placebo for the treatment of overall and negative symptoms of schizophrenia, but olanzapine generally compares more favourably with conventional antipsychotics. Firm conclusions regarding the comparison between olanzapine and ziprasidone require additional published trials on ziprasidone, particularly in direct comparison with olanzapine.