Correlation between hospital-acquired pneumonia and psychotropic treatments in patients with schizophrenia

目的 探讨精神分裂症患者医院获得性肺炎与精神药物治疗的相关性.方法 对温州康宁医院5年间顺序出院的普通精神科精神分裂症患者2037人进行回顾性调查分析.结果 医院获得性肺炎85例(4.17％),经Logistic回归分析发现医院获得性肺炎与抗精神病药物剂量、加药速度、使用氯氮平、利培酮、氟哌啶醇注射剂、氯硝西泮注射剂、氯硝西泮片等7个因素相关.结论 精神分裂症医院获得性肺炎与抗精神药物治疗种类、方式、剂量、途径以及联合使用苯二氮(革)类药物等医源性因素有关.     

女性精神分裂症患者应用苯二氮类药物分析

目的分析苯二氮类(BDZ)药物在女性精神分裂症患者中的应用情况。方法采用自制量表对住院的119例女性精神分裂症患者使用BDZ情况进行调查。结果抗精神病药物合用BDZ者56例(4706%)，以应用硝西泮、氯硝西泮为多。结论苯二氮类辅助抗精神病药治疗精神分裂症使用率很高，疗效好，使用安全，但临床上应注意合理用药，避免医源性药物依赖。     

女性精神分裂症患者应用苯二氮(艹卓)类药物分析

目的分析苯二氮NFDA8类(BDZ)药物在女性精神分裂症患者中的应用情况.方法采用自制量表对住院的119例女性精神分裂症患者使用BDZ情况进行调查.结果抗精神病药物合用BDZ者56例(47.06%),以应用硝西泮、氯硝西泮为多.结论苯二氮(艹卓)类辅助抗精神病药治疗精神分裂症使用率很高,疗效好,使用安全,但临床上应注意合理用药,避免医源性药物依赖.     

女性精神分裂症患者应用苯二氮Zhuo革类药物分析

目的分析苯二氮Zhuo类(BDZ)药物在女性精神分裂症患者中的应用情况。方法采用自制量表对住院的119例女性精神分裂症患者使用BDZ情况进行调查。结果抗精神病药物合用BDZ者56例(47．06％)，以应用硝西泮、氯硝西泮为多。结论苯二氮Zhuo类辅助抗精神病药治疗精神分裂症使用率很高，疗效好，使用安全，但临床上应注意合理用药，避免医源性药物依赖。     

盐城市第四人民医院住院老年精神分裂症患者抗精神病药物用药情况调查

目的分析盐城市第四人民医院住院老年精神分裂症患者抗精神药物使用情况,以期指导临床合理用药。方法回顾性分析2013年1月-2014年12月医院1061例老年抗精神药物使用情况,比较2年抗精神药物使用变化。结果 2年内联合用药比例分别是44.51%、43.23%,联合用药比例有所降低;从用药频率来看,目前主要抗精神药物是奥氮平(23.28%)、利培酮(20.45%)、喹硫平(17.15%)、阿立哌唑(7.72%),用药剂量分别为(13.4±2.2)mg/d、(2.6±0.6)mg/d、(345.5±43.4)mg/d、(11.5±2.1)mg/d。结论就目前来看,老年类抗精神药物单一用药还是占主导,且以非典型抗精神病药物为主,用药剂量均较小。     

门诊精神分裂症患者使用苯二氮类药物调查

目的了解门诊精神分裂症患者对于苯二氮类(BZ)药物的使用情况。方法采用随机抽取在门诊治疗的80例精神分裂症患者,分析苯二氮类药物的使用情况。结果在80例门诊患者中使用苯二氮类药物43例(53.75%),使用氯硝西泮的居多。结论苯二氮类药物联合抗精神病药物治疗精神分裂症有很好的增效作用,但使用时间长、效率高,临床上要注意其不良反应,合理用药。     

抗精神药物对精神分裂症患者甲状腺激素的影响分析

目的观察探讨抗精神药物对精神分裂症患者甲状腺激素的影响分析。方法选取我院自2008年1月至2010年12月收治的精神分裂症患者60例随机分为观察组(服用抗精神药物组)和对照组(健康组)各30例,治疗周期均为8周,以阳性症状和阴性症状量表(PANSS)观察疗效,测定治疗前、后血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)水平并,观察两组的治疗效果。结果血清甲状腺激素水平治疗前精神分裂症患者与健康受试者比较,无显著性差异(P>0.05),有可比性;治疗后,观察组与对照组患者比较,观察组(服用抗精神药物组)的T3、T4水平均降低,TSH升高,与治疗前比较差异有统计学意义(P<0.05)。结论抗精神药物对精神分裂症患者甲状腺激素的影响效果显著,值得临床推广使用。     

综合性医院精神药物与抗精神药物处方使用调查

采用“限定日剂量(DDD)”作为药物使用研究的测量单位,“药物使用指数(DUI)”作为技术指标对综合性医院精神药物与抗精神药物处方进行分析。结果表明:(1)两家医院精神药物与抗精神药物的使用基本合理,无明显滥用倾向;(2)含精神药物或抗精神药物处方占处方总数的8.55%,且99.96%的只含一种精神药物或抗精神药物;(3)苯二氮(艹卓)类是使用较多的品种,但19～35a年龄组,则以使用谷维素为多;(4)多数药物使用指数偏低,提示用药剂量不足。     

氯硝西泮联合利培酮治疗精神分裂症疗效观察

目的:观察氯硝西泮联合利培酮治疗精神分裂症急性期兴奋的疗效和不良反应。方法:将100例精神分裂症患者随机分为两组,分别以氯硝西泮联合利培酮(联合组)和氯氮平单用(单用组),以阳性症状与阴性症状量表(PANSS)及不良反应量表(TESS)评定疗效和安全性,疗程6周。结果:联合组精神分裂症阳性症状及阴性症状均有效,与单用组相似,不良反应明显较单用组少而轻。结论:氯硝西泮联合利培酮能有效治疗精神分裂症急性期兴奋,不良反应少,安全性好。     

我院第2类精神药品的应用分析

目的 分析我院第2类精神药品的应用情况.方法 选择我院使用的含第2类精神药品的处方1296张.分析患者年龄、性别、所用药品、用药剂量和用药总天数等.结果 本组患者女893例(68.9%);男403例(31.1%).药品应用频率由高到低依次为艾司哇仑、地西泮、氯硝西泮、唑哇吡坦、苯巴比妥、硝西泮.门诊常用6种精神药物的DUI均<1.0.结论 我院第2类精神药品临床用药较为合理,但仍存在少数不合理用药的现象.     

住院精神分裂症患者抗精神病药物使用情况调查

目的 了解住院精神分裂症患者抗精神病药的使用情况,了解影响精神分裂症患者用药的因素.方法 采用横断面方法对住院精神分裂症患者使用药物的情况进行调查.结果 本次调查465例患者涉及47种药物治疗方案,使用1种抗精神病药物175例(37.6%),联用2种种抗精神病药物262例(56.3%),联用3种种抗精神病药物28例(6.0%),联用2种抗精神病药物治疗在住院患者中非常多见;氯氮平使用率和处方占有率排在第一,非典型抗精神病药物已占精神分裂症治疗用药的主导地位;公费医疗患者选择非典型抗精神病药物明显高于非公费医疗患者.结论 在精神分裂症治疗用药中,非典型抗精神病药物逐渐取代了典型抗精神病药物,并且患者费用支付方式影响抗精神病药物的选择.     

精神分裂症病人无抽搐电休克期间用药情况分析

目的探讨住院精神分裂症病人在进行无抽搐电休克时服用抗精神病药物情况。方法对90例住院精神分裂症病人在进行无抽搐电休克时服用抗精神病药物的情况进行分析。结果90例病人无抽搐电休克治疗时服用药物一般维持在治疗量的中间值,在药物的选择上以利培酮最多。结论无抽搐电休克治疗不影响药物的选择、合并用药,但用量较治疗量小。     

非典型抗精神病药物对精神分裂症患者记忆功能的影响

目的探讨精神分裂症患者经非典型抗精神病药物治疗后记忆功能的变化究竟是有改善还是下降。方法选2010年1月～2012年1月就诊于本院的精神分裂症患者120例,随机分成治疗组和对照组各60例。治疗组用非典型抗精神病药物,对照组用典型性抗精神病药物治疗。在治疗期间进行记忆检测评估并对比评分差异。结果通过不同类型抗精神病药物治疗后治疗组与对照组对比差异有统计学意义（P〈0．05）,服非典型抗精神病药患者评分随时间推移,缓步改善（P〈0．05）。结论精神分裂患者服用非典型抗精神病药物的记忆功能有改变．起到了良好的改善作用。     

首次与多次住院精神分裂症患者抗精神病药使用调查

目的:了解首次住院与多次住院精神分裂症患者的抗精神病药用药情况。方法:采用一日法,对我院首次与多次住院精神分裂症患者抗精神病药使用情况进行调查,并对两者的调查结果进行比较。结果:在药物使用种类上,首次与多次住院患者使用频率排前5位的均为非典型性抗精神病药,首次住院患者用药频率最高的是奥氮平,多次住院患者用药频率最高的是氯氮平;首次住院精神分裂症患者在单一用药及非典型抗精神病药物的使用率上明显高于多次住院患者,差异均有统计学意义(P<0.05);在合并苯海索片、心境稳定剂、抗抑郁药、苯二氮类药上,两者差异无统计学意义。结论:我院首次住院精神分裂症患者在单一用药及非典型抗精神病药物的使用率上均高于多次住院患者,氯氮平较少用于首次住院患者。     

Perspectives in chemotherapy of schizophrenic psychoses.

1. The treatment of schizophrenic symptoms has not the same efficacy in acute and chronic phases of the disease and on the various target symptoms of schizophrenia. 2. The ideal antipsychotic drug might have different properties, sometimes contradictory, to be effective both on paranoid and hebephrenic symptoms which seem to be a mirror image of the same disorder. 3. Basic perspectives in the chemotherapy of schizophrenic psychoses must be founded on better methodological considerations in clinical trials, on a better use of antipsychotic drugs with the help of pharmacokinetic data and computerized EEG and also on new neurochemical findings. 4. Recent data on the mode of action of neuroleptics open up new therapeutic classes of drugs. Such are GABA-like drugs and, more recently, beta-blockers.     

Acute risperidone treatment did not increase daily cigarette consumption or plasma levels of cotinine and caffeine: a pilot study

Excessive cigarette smoking and caffeine intake are often seen in schizophrenic patients being treated with antipsychotic drugs, particularly typical antipsychotic drugs. Using nicotine and caffeine sometimes influences psychotic symptoms in these patients. Clozapine is the only antipsychotic drug reported to reduce the amount of cigarette smoking, however, still remains controversial of its efficacy. In the present study, we examined the effect of acute risperidone treatment on the amount of cigarette smoking and plasma levels of cotinine and caffeine in schizophrenic patients. Treatment with risperidone for 4 weeks did not increase daily cigarette consumption or plasma levels of cotinine and caffeine. The results suggest that acute risperidone treatment does not promote the intake of nicotine and caffeine at least by 4 weeks in schizophrenic patients.     

Effects of controlled-release formulations of atypical antipsychotics on functioning and quality of life of schizophrenic individuals

INTRODUCTION: Controlled-release formulations of atypical antipsychotics have recently been introduced into clinical practice. Clinical studies have indicated that these new therapies induce meaningful improvements in the functioning and quality of life of schizophrenic individuals. AREAS COVERED: The present analysis makes an attempt to address the clinical relevance of these studies and their contribution to the understanding of the mechanisms of action of these new drugs. A Medline search was done using the keywords 'antipsychotic', 'plasma level', 'quality of life' and 'functioning'. EXPERT OPINION: After reviewing the literature, it seems that symptom control and side effects may play a role in modulating the functioning and quality of life of schizophrenic individuals treated with controlled-release formulations of atypical antipsychotics. The analysis also highlights that these new drugs may possess peculiarities and similarities in regulating patient functioning. However, the low number of clinical analyses that have focused on these aspects of antipsychotic therapy limits the interpretation of the results. Additional comparative clinical trials are needed to evaluate how the pharmacokinetic/pharmacodynamic properties of antipsychotic drugs may modulate the functioning and quality of life of schizophrenic individuals, as well as to establish whether new clinical benefits may come from the use of these drugs in schizophrenia therapy.     

The prevalence of antipsychotic polypharmacy in schizophrenic patients discharged from psychiatric units in Poland

BackgroundThe term antipsychotic polypharmacy (APP) refers to the concurrent use of two or more antipsychotic drugs in schizophrenia. The aim of this study was to investigate the range of APP in schizophrenic patients discharged from psychiatric units in Poland, and to determine its demographical and clinical correlates.MethodsData on the pharmacological treatment of 207 patients with a diagnosis of schizophrenia, discharged from six psychiatric hospitals from September–December 2011 were recorded by experienced psychiatrists. Clinical and demographical information was obtained on each patient. The severity of symptoms at admission, and their improvement during hospitalization were assessed using the Clinical Global Impression Scale.ResultsAt discharge, 52.7% of the patients were prescribed one, 42.5% two and 4.8% three antipsychotic drugs (AP). When two AP were applied, it was usually a combination of two second generation antipsychotics (SGA) (46%), or of both first generation antipsychotics (FGA) and SGA (48%). The SGA's olanzapine and risperidone were those most commonly prescribed. Patients treated with two or more AP had a higher number of previous hospitalizations than patients receiving antipsychotic monotherapy. Mood stabilizers were prescribed for nearly one third of the patients, while antidepressants and benzodiazepines were prescribed for fewer than 10%.ConclusionsThe prevalence of polypharmacy in Poland is similar to that reported in other countries. This may suggest that, in a substantial proportion of schizophrenic patients clinical response to the antipsychotic monotherapy is unsatisfactory. Further studies focusing on the efficacy and safety of strategies in the treatment of patients with schizophrenia not responding to antipsychotic monotherapy are necessary.     

Efficacy of adjunctive carbamazepine in the treatment of chronic schizophrenia

Six treatment-resistant schizophrenic patients were given a ten-week single-blind trial of carbamazepine. Treatment resistance was determined on the basis of documented failure to respond to treatment with at least three neuroleptic drugs from two different chemical classes. The adjunctive use of carbamazepine resulted in a significant improvement of the negative symptoms of schizophrenia. These symptoms are often poorly responsive to conventional antipsychotic drugs. Therefore, controlled studies should be performed to further assess the possible efficacy of carbamazepine in schizophrenia.     

Effects of depot drug formulations in procedures used to evaluate antipsychotic activity in rodents

The use of long‐acting depot antipsychotics results in an increase in compliance and significantly decreases rates of relapse and rehospitalization of schizophrenic patients. However, the assessment of activity of such drugs in small animals is not as straightforward as the evaluation of acutely active drugs. Previous studies have investigated the effects of depot formulations by assessing their activity in preclinical methods that examine their striatal dopaminergic components alone. These methods are currently used to examine the extrapyramidal side‐effects of antipsychotic agents. In the light of recent drug developments, however, it is possible that such procedures may no longer be appropriate for testing antipsychotics which produce fewer side effects and which have a broader range of action including nondopaminergic components. Accordingly, the present study aimed to further investigate the activities of clinically used depot antipsychotics by using procedures that are considered more predictive of antipsychotic activity rather than extrapyramidal side‐effect liability. Along with acutely active analogs, flupenthixol decanoate, fluphenazine decanoate, and haloperidol decanoate were examined in the following procedures with rats or mice: antagonism of 1[2,5‐dimethoxy‐4‐iodophenyl]‐2‐aminopropane (DOI) ‐induced behaviors and amphetamine‐stimulated locomotion. Effects of the depot formulations in both procedures were determined at time points ranging from 24 h to 14 days after administration. In general, some antipsychotic‐related effects were observed with the drugs particularly at earlier time points; effects at 14 days were minimal. The results from this study demonstrate that depot formulations of antipsychotic drugs have effects in rodents, but factors possibly related to injection volume, test procedure, and species could limit the duration of action in small laboratory animals. Drug Dev. Res. 47:27–36, 1999. © 1999 Wiley‐Liss, Inc.