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。     

棕榈酸帕利哌酮与癸酸酯氟哌啶醇长效针剂治疗首发精神分裂症患者随机对照研究

目的 评估棕榈酸帕利哌酮与癸酸酯氟哌啶醇长效针剂治疗首次发作精神分裂症的临床疗效和安全性.方法 随机抽取门诊或住院92例首发精神分裂症患者,利用随机数字表法分为研究组(棕榈酸帕利哌酮长效针剂)与对照组(癸酸酯氟哌啶醇长效针剂),治疗前及治疗后3,6,9,12个月阳性与阴性症状量表(PANSS)及总分评定疗效,同时采用不...     

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。     

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。     

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     

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.     

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.     

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...     

氟哌利多与氟哌啶醇治疗急性躁狂症的比较

３４例急性躁狂症随机分配至氟哌利多组（男性１１例，女性７例；年龄２８±ｓ１０ａ）和氟哌啶醇组（男性１０例，女性６例；年龄２９±１２ａ）治疗。２药的治疗剂量均为１０－２０ｍｇ，ｉｍ，ｂｉｄ，疗程２ｗｋ。用ＢＲＭＳ、ＣＧＩ－ＳＩ、ＧＡＳ及ＴＥＳＳ量表评定。结果显示：２药疗效相仿：２组ＢＲＭＳ和ＣＧＩ－ＳＩ总分的减分及ＧＡＳ总分的增分差异不显著（Ｐ＞０．０５）；２药主要不良反应为锥体外系反应。     

Practical guidelines on the use of paliperidone palmitate in schizophrenia

Abstract

Objective:

Paliperidone palmitate is an atypical long-acting injectable (LAI) antipsychotic that has been approved for use in the US, EU, Australia and numerous other countries for acute and maintenance therapy of schizophrenia.

LAI antipsychotics are often viewed as a ‘last-resort’ treatment for difficult-to-treat patients, however this article considers their role more broadly in the management of partial or non-adherence in schizophrenia.     

齐拉西酮注射液治疗精神分裂症激越症状的研究

目的本研究应用氟哌啶醇注射液作为对照,评价齐拉西酮注射液治疗精神分裂症激越患者的疗效、安全性和耐受性。方法连续入组急性精神分裂症患者,按照1：1的比例随机分配到齐拉西酮注射液治疗组（试验组）和氟哌啶醇注射液治疗组（对照组）,对患者进行筛选访视、基线访视,以及肌注治疗第一剂药后的2、4、24、48h和72h的访视。采用简明精神评定量表（BPRS）评价主要疗效,Simpson-Angus量表评定药物的锥体外系反应。结果两组均纳入受试者30例。药物治疗72h后与基线比较,试验组BPRS总分减分平均为12.55±6.88,对照组BPRS总分减分平均为15.60±5.94。两组主要疗效指标差异无统计学意义（P=0.110）。试验组未见锥体外系不良反应,Simpson-Angus量表评分在治疗前后差异无统计学意义（P=0.16）;对照组出现锥体外系不良反应,治疗前后差异有统计学意义（P=0.02）。结论甲磺酸齐拉西酮注射液能够快速有效控制精神分裂症急性激越症状,疗效与氟哌啶醇注射液相当,不良反应轻微,安全性、耐受性好,值得临床推广应用。     

Real-world outcomes post-transition to once-every-3-months paliperidone palmitate in patients with schizophrenia within US commercial plans

Objectives: To compare comorbidity-related outcomes, adherence to antipsychotics (APs), healthcare resource utilization (HRU), and costs pre- and post-transition to once-every-3-months paliperidone palmitate (PP3M) in commercially-insured patients with schizophrenia.

Methods: Adults with ≥1 claim for PP3M, ≥2 schizophrenia diagnoses, and adequate treatment with once-monthly paliperidone palmitate (PP1M; i.e. no gap of >45?days in PP1M coverage for ≥4?months, same PP1M dosage for the last two PP1M claims, and appropriate PP1M to PP3M dosing conversion) were selected from the IQVIA PharMetrics Plus database (May 2014–February 2018). Generalized estimating equation models adjusted for repeated measurements were used to compare patient characteristics, adherence to APs, HRU, and costs during the 6-month period pre- vs post-transition to PP3M.

Results: Of 152 included patients, the mean age was 41.0?years and 36.2% were females. Post-PP3M transition, patients were less likely to have a claim with a diagnosis for substance-related and addictive disorders (odds ratio [OR]?=?0.57), psychoses (OR?=?0.57), diabetes without chronic complication (OR?=?0.72), and drug abuse (OR?=?0.64; all p?<?.05). Patients were more likely to be adherent to APs (OR?=?2.01, p?=?.007), compared to the period pre-PP3M transition. There was no significant difference in HRU pre- vs post-transition. All-cause total (mean monthly cost difference [MMCD]?=?$242), pre-rebate pharmacy (MMCD?=?$65), and medical costs (MMCD?=?$176) remained similar pre- vs post-transition (all p?>?.05).

Conclusions: Transitioning to PP3M was associated with an improvement in adherence and in comorbidity-related outcomes related to substance-related and addictive disorders, psychoses, diabetes without chronic complication, and drug abuse. These findings suggest PP3M may enhance comorbidity-related outcomes and adherence while remaining cost neutral.