哌泊塞嗪棕榈酸酯与氟哌啶醇癸酸酯治疗精神分裂症的对比

精神分裂闰从６１例机双盲分为哌泊塞嗪组（男性２５例，女性６例，年龄４０±ｓ９ａ，每４ｗｋｉｍ１次，平均剂量１１０±３５ｍｇ／４ｗｋ，共６次）和氟哌啶醇组（男性２４例，女性６例，年龄３８±９ａ，每４ｗｋｉｍ１次，平均剂量１２０±２８ｍｇ／４ｗｋ，共６次）。结果：ＢＰＲＳ减分率，总显效率，生效时间组差别无显意义。     

哌泊塞嗪治疗精神分裂症90例浅析

目的了解哌泊塞嗪治疗精神分裂症的疗效。方法对90例精神分裂患者给予哌泊塞嗪治疗,先停服其他抗精神病药物,初始剂量25m g/2周,根据病情变化每2周递增25m g,最大剂量100m g/2周。在治疗前后进行BPRS评分。结果经过5个月治疗,显著进步15例,进步54例,无效21例,总有效率76.67%,无效率23.33%。结论哌泊塞嗪对精神分裂症有一定的疗效,是一种治疗方便、易于保管、副作用较少、适合家庭治疗的抗精神病药物。     

氟哌啶醇癸酸酯治疗慢性期残留型精神分裂症7例报告

目前我国慢性精神分裂症患者正在逐年增多,寻求防治方法是一项艰巨而迫切的任务。氟哌啶醇癸酸酯(HD)是种新型长效的抗精神病药物,自1985年在我国应用于临床以来,很受精神科医生的重视,但少有治疗慢性期残留型精神分裂症的报道。本文采用序贯设计方法,陆续对入我病区的7例患者进行为期4个月的治疗,现将结果报告如下。     

氟哌啶醇癸酸酯治疗难治性精神分裂症34例临床分析

目的:了解氟哌啶醇癸酸酯治疗难治性精神分裂症疗效。方法:34例均符合DSM-Ⅲ-R中难治性精神分裂症停用其它抗精神病药物后1周,给予氟哌啶醇癸酸酯50～150mg/月,疗程16周至48周,治疗前后测定BPRS量表一次。结果:氟哌啶醇癸酸酯治疗难治性精神分裂症其显效率52.9％,有效率85.3％。结论:氟哌啶醇癸酸酯对难治性精神分裂症有效,副作用比较轻微。     

氟哌啶醇癸酸酯注射液治疗精神病17例

木文报告应用进口氟哌啶醇癸酸酯注射液治疗17例男性精神病患者,年龄31±(SD)12岁,病程6±6yr(年),疗程6mo(月)。治疗结果:总有效率为65％,副作用少。是一种安全长效抗精神病药物。     

阿立哌唑与氟哌啶醇治疗精神分裂症对照研究

目的评价阿立哌唑与氟哌啶醇治疗精神分裂症的疗效及安全性。方法阿立哌唑组35例,氟哌啶醇组36例,以阳性与阴性症状量表（PANSS）、临床疗效总评量表疾病严重程度（CGI—SI）、治疗中出现的症状量表（TESS）、锥体外系反应量表（RSESE）评定疗效及不良反应。疗程6周。结果两组疗效相仿。阿立哌唑组PANSS阴性症状因子减分在治疗后4周及6周显著优于氟哌啶醇组。阿立哌唑组不良反应显著较少。结论阿立哌唑是一种有效安全的抗精神病药。     

阿立哌唑与氟哌啶醇治疗精神分裂症的对照研究

目的探讨阿立哌唑治疗精神分裂症的疗效及安全性。方法按照CCMD-3诊断标准选择110例住院精神分裂症患者,并随机分为阿立哌唑组（58例）及氟哌啶醇组（52例）分别进行治疗。疗程为8周。结果在治疗第8周末,两组的显效率分别为74.48%和68.42%（P〉0.05） 两组的PANSS总分的减分率分别为69.6%和66.5%（P〉0.05） 两组治疗前后的PANSS总分及各分量表分同组比较有统计学差异（P〈0.01）,两组间比较除治疗末PANSS的阴性症状分阿立哌唑组较低,且有统计学差异（P〈0.01）外,其他差异均无统计学意义（P〉0.05）。其次,阿立哌唑组不良反应为焦虑、头痛、失眠、胃肠道反应等,未发现有明显的体质量增加、嗜睡、锥体外系反应。结论阿立哌唑治疗精神分裂症的阳性及阴性症状有较好疗效,不良反应较微,安全性良好。     

阿立哌唑与氟哌啶醇治疗首发精神分裂症随机对照研究

目的:评价阿立哌唑治疗首发精神分裂症的临床疗效及安全性。方法:87例首次住院的精神分裂症患者随机分为2组,分别给予阿立哌唑、氟哌啶醇治疗,疗程8周。治疗前及治疗2,4,8周末采用阳性与阴性综合征量表(PANSS)评定疗效,副反应量表(TESS)评定不良反应。结果:治疗8周末,阿立哌唑组有效率为91.11%;氟哌啶醇组有效率为88.10%;两组差异无统计学意义(P>0.05)。治疗2周末两组评分均较治疗前下降差异显著(P<0.01),随治疗时间的延长两组疗效差距逐渐缩小。结论:阿立哌唑治疗精神分裂症起效时间短于氟哌啶醇,远期疗效优于氟哌啶醇;且安全性高,依从性好。     

氟哌啶醇癸酸酯穴位注射治疗精神分裂症难治性听幼觉

６０例精神分裂症难治性听幻觉病人采用氟哌啶醇癸酸酯（ＨＤ）进行听宫，医风穴位注射治疗，按阳决症状量表（ＳＡＰＳ）评价结果分析，总分均值及幻觉因子分治疗前后相比，有极显著差异（Ｐ＜０．０１），表明ＨＤ对精神分裂症难治性听幻觉有较好效效。     

氯硝西泮治疗精神运动性兴奋与氟哌啶醇的比较

伴有精神运动性兴奋的精神病患者３８例（男性１７例，女性２１例；年龄３１±ｓ１１ａ），用氯硝西泮１－３ｍｇ，ｉｍ，ｂｉｄ共１ｗｋ。另外相似患者２９例（男性１８例，女性１１例；年龄３０±１１ａ），用氟派啶醇１０－１５ｍｇ，ｉｍ，ｂｉｄ共１ｗｋ。结果前组总有效率９５％，后组为９０％ｆＰ＞０．０５）。２组的不良反应有嗜睡，共济失调，扭转性痉挛，心动过速，口齿不清等。值得采用氯硝西泮治疗此症。     

Disposition of haloperidol and reduced haloperidol plasma levels after single dose haloperidol decanoate administration

A single dose of haloperidol decanoate 100 mg was administered to 15 schizophrenic patients. Blood samples were obtained prior to injection, 1 h, 3 h, 6 h, 8 h, 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, one week, two weeks, three weeks and four weeks post-injection. Haloperidol and its reduced metabolite, reduced haloperidol, plasma levels were assayed by HPLC with electrochemical detection. The pharmacokinetic parameters of haloperidol were determined. The mean time of maximal (T_max) plasma levels for haloperidol was 5·73 ± 0·80 days. The haloperidol plasma levels showed a biexponential decline with an elimination half-life of 15·78 ± 5·90 days. Reduced haloperidol was rapidly formed from the haloperidol. The T_max of reduced haloperidol was 7·00 ± 2·35 days. The mean ratio reduced haloperidol/haloperidol was 0·155 ± 0·111. Since the T_max occurs at approximately six days, a weekly loading dose of haloperidol decanoate is feasible during the transition from oral to depot therapy.     

Reduced haloperidol plasma concentration and clinical response in acute exacerbations of schizophrenia

Twenty-nine hospitalized patients suffering acute exacerbations of schizophrenia were treated for 2 weeks with fixed daily oral doses of haloperidol prospectively calculated to achieve a haloperidol plasma concentration of either 8–18 ng/ml or 25–35 ng/ml. Reduced haloperidol as well as haloperidol concentrations were assayed to determine if the former enhanced the predictability of response. Week 2 haloperidol plasma concentrations were negatively correlated to clinical response as measured by the percentage change in the BPRS score from baseline (r=–0.43,P<0.05). In contrast, week 2 plasma concentrations of reduced haloperidol, total haloperidol (haloperidol+reduced haloperidol), and reduced haloperidol/haloperidol ratio did not correlate with the change in the BPRS score. Chi-square analysis concluded that patients with ratios greater than one were no less likely to be treatment responders (<25% improvement in BPRS from baseline and week 2 BPRS <55) than those with ratios less than one. Although these data lend additional support to reports of a curvilinear relationship between haloperidol plasma concentration and clinical response, they also suggest that reduced haloperidol plasma concentrations are of no value in predicting treatment response.From the Mental Health Research Center — Major Psychoses, funded in part by NIMH Grant #5 P50 MH43271     

顶空-气相色谱法测定棕榈哌泊噻嗪中残留溶剂

目的 建立顶空-气相色谱法测定棕榈哌泊噻嗪中甲醇、环己烷、甲苯、二甲苯4种有机溶剂残留量的方法.方法采用PC-624毛细管柱(60 m×0.32 mm,1.8 μm),程序升温,FID检测器,检测器温度为230℃,进样口温度为150℃,顶空平衡温度为100 ℃,顶空平衡时间为30 min,二甲基甲酰胺为溶剂.结果 4种有机溶剂及二甲苯的3个峰完全分离,且线性关系良好,平均回收率为99.7％～99.9％.结论 该方法灵敏度和准确度均达到有机溶剂残留量检测的要求,可用于棕榈哌泊噻嗪中有机溶剂残留量的测定.     

Paliperidone palmitate: Japanese postmarketing mortality results in patients with schizophrenia

Objective: Paliperidone palmitate once-monthly injectable (PP1M) is approved in Japan and other countries for the treatment of schizophrenia. During the 6 month Japanese early postmarketing phase vigilance (EPPV) period, 32 deaths were reported. This report reviews potential contributing factors to the fatal outcomes in the PP1M-treated population.

Research design and methods: All spontaneously reported adverse events following PP1M use received during EPPV from 19 November 2013 to 18 May 2014 were entered into the global safety database and these events were analyzed.

Results: During the EPPV period, 10,962 patients were estimated to have been treated with PP1M in Japan. The mortality reporting rate during this EPPV period was higher than that observed in the US or globally after PP1M launch (5.84, 0.43, and 0.38 per 1000 patient-years, respectively), but was consistent with the mortality incidence rates (10.2 per 1000 person-years) observed during interventional clinical studies in Japan and in observational patient cohorts. Of the 32 deaths reported during the Japanese PP1M EPPV period, 19/32 (59.4%) were in patients over 50 years of age, 23/32 (71.9%) reported cardiovascular risk factors and 25/32 (78.1%) received antipsychotic polypharmacy.

Conclusions: Based on this review of the 32 fatal cases in the PP1M EPPV period, the observed death rate does not necessarily result from a risk with PP1M treatment in Japanese patients. The higher mortality reporting rates in Japan may be attributed to a variety of factors: the effectiveness of mortality reporting in the unique Japanese EPPV program, the advanced age of the fatal cases, high cardiovascular risk factors, multiple underlying diseases and high antipsychotic polypharmacy among the cases with fatal outcomes.     

棕榈酸帕利哌酮PP1M治疗精神分裂症的药物经济学研究进展

目的 系统总结棕榈酸帕利哌酮(PP1M)治疗精神分裂症的药物经济学相关研究结果,为抗精神病药的临床应用提供依据.方法 系统检索Taylor&Francis、ScienceDirect、PubMed、Embase、CBM、中国知网和万方数据库等,检索时间从建库至2019年12月,纳入2015～2019年棕榈酸帕利哌酮(P...     

Differential efficacy of risperidone versus haloperidol in psychopathological subtypes of subchronic schizophrenia

The aim of this study was to evaluate the efficacy and tolerability of risperidone versus haloperidol in subchronic schizophrenia, using psychopathological subgroups of patients with negative or positive and mixed symptoms to analyse the possible differential efficacy of the drugs. A total of 33 patients diagnosed using DSM-IV criteria entered the 6 week double-blind study with either risperidone or haloperidol 5 mg/day. Twenty-nine patients completed at least 2 weeks of treatment and entered the last observation carried-forward analysis. Both treatments were effective in reducing total scores and positive and negative subscale scores on the Positive and Negative Scale for Schizophrenia (PANSS), with a significantly better extrapyramidal profile in the risperidone-treated group. When analysis was repeated in each treatment group by psychopathological subtype (negative vs positive-mixed subgroups based on the PANSS composite index), risperidone was significantly superior to haloperidol in the intention to treat analysis in the negative subgroup. Repeated measures multivariate analysis of variance showed a significantly greater improvement in the PANSS negative subscale scores of risperidone-treated patients in the negative subgroup and a significant improvement in the PANSS positive subscale scores in both psychopathological subtypes. Haloperidol was significantly effective only in reducing positive symptoms in the positive subtype. Our results indicate that risperidone may be proposed for first-line treatment of subchronic schizophrenia, in particular the negative subtype. Copyright 2001 John Wiley & Sons, Ltd.     

哌泊噻嗪氯氮平治疗精神分裂症阴性症状26例

目的;研究哌泊噻嗪合并氯氮平对阴性症状的疗效。方法：将５０例以阴性症状为主的精神分裂症患者随机分为氯氮平合并哌泊噻嗪组２６例和单用氯氮平组２４例,采用临床疗效评定,简明精神病量表（ＢＰＲＳ）,阴性症状量表（ＳＡＮＳ）。结果：哌泊噻嗪合并氯氮平组显效率５８．０％,ＳＡＮ减分率６６．０％,氯氮平组显效率３５．０％,ＳＮＡＳ减分率５３．４％,经ｕ检查,两者均差异显著（Ｐ〈０．０５）。结论：哌泊噻嗪合并氯     

Short-term rehospitalizations in young adults with schizophrenia treated with once-monthly paliperidone palmitate or oral atypical antipsychotics: a retrospective analysis

Objective: To compare rehospitalizations in patients with schizophrenia treated with paliperidone palmitate (PP1M) vs oral atypical antipsychotics (OAAs), with a focus on young adults (18–35 years).

Methods: The Premier Healthcare database (January 2009–December 2016) was used to identify hospitalizations of adults (≥18 years) with schizophrenia treated with PP1M or OAA between September 2009 and October 2016 (index hospitalizations). Rehospitalizations were assessed at 30, 60, and 90 days after each index hospitalization in young adults and in all patients. Proportions of index hospitalizations resulting in rehospitalization were reported and compared between groups using odds ratios (ORs) and 95% confidence intervals (CIs).

Results: A total of 8578 PP1M and 306,252 OAA index hospitalizations were included. Hospitalized young adults treated with PP1M (n?=?3791) were more likely to be seen by a psychiatrist (94.0% vs 90.0%), and had a longer length of stay (12.5 vs 8.6 days) compared to hospitalized young adults treated with OAA (n?=?96,502). Following their discharge, young adults receiving PP1M during an index hospitalization had a 25–27% lower odds of rehospitalization within 30, 60, and 90 days compared to young adults receiving OAAs (all p?<?.001). Similarly, when observing all patients, those receiving PP1M during an index hospitalization had 19–22% lower odds of rehospitalization within 30, 60, and 90 days compared to those receiving OAAs (all p?<?.001).

Conclusions: Following a hospitalization for schizophrenia, PP1M treatment was associated with fewer 90-day rehospitalizations among young adults (18–35 years) relative to OAA treatment. This finding was also observed in other hospitalized adults with schizophrenia.