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1.
奥氮平治疗精神分裂症的疗效与其血药浓度的相关性分析   总被引:3,自引:0,他引:3  
目的 探讨奥氮平治疗精神分裂症的疗效、副反应与血药浓度的关系 ,有效血药浓度的范围。方法 用阴性与阳性症状量表 (PANSS)、简明精神病评定量表 (BPRS)、社会功能缺陷筛选量表 (SDSS)和副反应量表 (TESS)评定疗效和副反应 ;用反相高效液相色谱法测定病人第 1、8周末的奥氮平血药浓度。结果 奥氮平能明显降低精神分裂症病人的阳性和阴性症状评分 (P <0 0 1) ,副反应主要为嗜睡、口干和体重增加。奥氮平的血药浓度个体差异较大 ,最高浓度为 5 9 83ng/mL ,最低浓度为 3 71ng/mL ,在此浓度范围内 ,奥氮平血药浓度与剂量成正相关 (r=0 3 3 ,P =0 0 2 1)。血药浓度大于 9ng/mL的病人疗效较好 (P <0 0 1) ;BPRS和SDSS的减分率与奥氮平血药浓度之间呈正相关 (P <0 0 5 )。结论 奥氮平能有效治疗精神分裂症 ,改善其社会功能障碍 ;其治疗精神分裂症的疗效与血药浓度有相关性 ,9ng/mL是奥氮平治疗精神分裂症适宜血药浓度的下限。  相似文献   

2.
奥氮平和氯氮平治疗精神分裂症老年患者的对照研究   总被引:2,自引:0,他引:2  
目的:对比奥氮平与氯氮平治疗精神分裂症老年患者的疗效和安全性。方法:对64例精神分裂症老年患者分别给予奥氮平、氯氮平治疗,其中奥氮平组30例,氯氮平组34例,疗程8周。以阳性症状和阴性症状量表(PANSS)、临床疗效总评量表(CGI)、简明精神病评定量表(BPRS)评定临床疗效。以副反应量表(TESS)和实验室监测评价安全性。结果:治疗结束时,两组PANSS和BPRS总分较治疗前显著降低,组间差异无显著性。两组间从治疗第1周起各时点PANSS减分率差异有显著性。临床有效率:奥氮平组76.7%,氯氮平组64.7%,两组相仿。奥氮平组不良反应较氯氮平组少,常见不良反应为胆碱能作用、嗜睡、体重增加和一过性肝酶升高等。结论:奥氮平治疗精神分裂症的疗效与氯氮平相似,某些不良反应较氯氮平轻而少;是一种安全有效、服用方便的新型抗精神病药。  相似文献   

3.
奥氮平治疗精神病的疗效,副反应与血药浓度的关系   总被引:1,自引:0,他引:1  
目的:分析奥氮平治疗精神病的疗效,副反应与血药浓度的关系.方法:用高效液相法测定病人的血药浓度,用阳性及阴性症状量表(PANSS),简明精神病评定量表(BPRS),社会功能缺陷筛选量表(SDSS)及副反应量表(TESS)评定其疗效和副作用.结果:奥氮平能显著降低阳性及阴性症状评价,且副反应轻微,剂量相同时,奥氮平血药浓度的个体差异较大,85%的病人的血药浓度在25-160nmol/L之间,其有效率为81.8%,浓度剂量的比值(C/D)与疗效呈正相关,结论:奥氮平能有效的治疗精神病,并改善社会功能障碍,25nmol/L是奥氮平适宜血药浓度的低限.奥氮平C/D值高的病人疗效好.  相似文献   

4.
奥氮平治疗儿童精神分裂症30例疗效观察   总被引:8,自引:2,他引:6  
目的:了解奥氮平治疗儿童精神分裂症的有效性及不良反应。方法:对30例儿童精神分裂症患者使用奥氮平治疗6周,采用阳性与阴性症状量表(PANSS),简明精神病评定量表(BPRS)和副反应量表(TESS)评价疗效和不良反应。结果:奥氮平治疗显效率为86.7%。常见不良反应为体重增加。结论:奥氮平疗效好,不良反应少,服用简便,依从性好,适用于儿童精神分裂症患者。  相似文献   

5.
奥氮平治疗难治性精神分裂症临床观察   总被引:13,自引:4,他引:9  
目的:评价奥氮平对难治性精神分裂症的疗效与不良反应。方法:对难治性精神分裂症80例换用奥氮平治疗24周。用阳性症状和阴性症状量表(PANSS)评定疗效,用副反应量表(TESS)及锥体外系副反应量表(ESRS)评定不良反应。结果:PANSS量表总分及各分量表评分疗后均有显著下降。最常见的不良反应是体重增加。结论:奥氮平对难治性精神分裂症疗效肯定,不良反应较轻。  相似文献   

6.
奥氮平门诊治疗首发精神分裂症23例临床分析   总被引:3,自引:1,他引:2  
目的 评价奥氮平治疗首发精神分裂症的疗效和安全性。方法 用奥氮平门诊治疗首发精神分裂症23例,疗程6周;采用阳性和阴性症状量表(PANSS)评价临床疗效,副反应量表(TESS)评价药物副反应。结果 治疗结束后,PANSS总分减分率为57.2%,显效率为86.4%,未见严重的不良反应。结论 奥氮平是一种疗效好、起效快、副反应少、服用方便、安全的抗精神病药,尤其适合不想住院的首发患者应用。  相似文献   

7.
加用银杏叶制剂治疗慢性精神分裂症的疗效观察   总被引:1,自引:0,他引:1  
目的了解银杏叶制剂(舒血宁)对慢性精神分裂症阴性症状的疗效和副反应。方法对48例经抗精神病药物治疗疗效不佳的病人,采用舒血宁片合并原抗精神病药物12周的动态观察治疗,用简明精神病评定量表(BPRS)、阴性症状量表(SANS)、副反应量表(TESS)和临床总体印象量表(CGI)评定患者症状变化和副作用。结果舒血宁片对慢性精神分裂症阴性症状有明显疗效,临床有效率为72.9%,BPRS总分,BPRS—ANEC分量表分,SANS总分.SANS五项总评以及CGI严重程度评分均明显下降,而且能减轻原抗精神病药物的副反应。结论舒血宁台并抗精神病药物治疗慢性精神分裂症阴性症状有较好的疗效。  相似文献   

8.
奥氮平治疗老年期精神障碍100例临床分析   总被引:4,自引:1,他引:3  
目的 评价奥氮平治疗老年期精神障碍的疗效和安全性。方法 用奥氮平治疗老年期精神障碍100例,其中,老年期分裂症40例,阿尔采默病28例,脑血管病所致精神障碍26例,脑外伤所致精神障碍6例,疗程8周;采用简明精神病量表(BPRS)、阳性和阴性症状量表(PANSS)评价临床疗效,副反应量表(TESS)评价不良反应。结果 BPRS总分、PANSS总分、阳性症状量表评分治疗后1、2、4、8周末,阴性症状量表评分治疗后1、2、4、8周末与治疗前比较差异有显著性(P〈0.05~0.01);奥氮平疗效显著,治愈率为72%,显效率为83%;常见的不良反应是体重增加。结论 奥氮平对老年期精神障碍起效快,不良反应少,安全有效,服用方便,适合于住院及门诊老年期精神障碍者的治疗。  相似文献   

9.
奎硫平治疗儿童青少年精神分裂症研究   总被引:6,自引:2,他引:4  
目的:探讨奎硫平对儿童青少年精神分裂症治疗的临床疗效和安全性:方法:对20例首次住院的儿童青少年精神分裂症患者使用奎硫平150~600mg/d治疗8周,以阳性与阴性症状量表(PANSS)评定疗效,用副反应量表(TESS)评价安全性。结果:PANSS总分在治疗后与治疗前比较差异有非常显著性。临床总有效率为70%。无严重不良反应。结论:奎硫平能缓解儿童青少年精神分裂症的精神病性症状。  相似文献   

10.
目的比较利培酮与舒必利对以阴性症状为主的精神分裂症的疗效及安全性。方法对62例以阴性症状为主的精神分裂症住院患者,随机分为利培酮组与舒必利组,疗程12周。于治疗前及治疗后1、2、4、8、12周末用阴性症状量表(SANS)、简明精神病量表(BPRS)评定临床疗效,用副反应量表(TESS)评定药物副反应。结果利培酮组与舒必利组治疗前后SANS、BPRS总分及减分比较差异无显著性(P0.05),各组治疗后SANS、BPRS总分与治疗前比较差异有极显著性(P0.01),而利培酮的副反应较舒必利少而轻。结论利培酮对以阴性症状为主的精神分裂症有肯定疗效,且安全性高。  相似文献   

11.
奥氮平治疗精神分裂症的开放性临床验证   总被引:74,自引:2,他引:72  
目的 验证奥氮平治疗精神分裂症的疗效和安全性。方法 对65例精神分裂症患者予以奥氮平在5~20mg/d治疗,疗程为6周,采用阳性与阴性症状量表以及简明精神病评定量表(BPRS)评定疗效,采用不自主运动量表,Simpson-Angus量表和副反应量表评定不良反应。结果 65例中脱落3例(在临床疗效评定中按无统计)完成治疗的62例中完全缓解52%(34/65),显著进步28%(18/65)进步8%(5  相似文献   

12.
奥氮平和奎硫平治疗首发精神分裂症对照研究   总被引:8,自引:0,他引:8  
目的:比较奥氮平和奎硫平治疗首发精神分裂症的疗效和安全性。方法:将80例符合中国精神障碍分类与诊断标准第3版诊断标准的首发精神分裂症患者,随机平分为奥氮平组和奎硫平组各40例。疗程6周。采用阳性与阴性症状量表(PANSS)、副反应量表(TESS)评定疗效与不良反应。结果:奥氮平组阳性症状评分下降显著大于奎硫平组;两组阴性症状、一般精神病理症状和PANSS总分下降差异无显著性(P>0.05)。奥氮平组主要不良反应为体质量(体重)增加、肝功能损害和锥体外系症状;奎硫平组主要不良反应为嗜睡和头昏。结论:奥氮平对精神分裂症阳性症状的疗效优于奎硫平,两药不良反应均相对较轻。  相似文献   

13.
BACKGROUND: The choice of drug to treat a patient with schizophrenia is one of the most critical clinical decisions. Controversy exists on the differential efficacy of olanzapine. DATA SOURCES AND STUDY SELECTION: Raw data from all 4 registrational double-blind, random-assignment studies of olanzapine compared with placebo or haloperidol were obtained from Eli Lilly and Company for this meta-analysis. METHOD: Analysis of covariance of the intent-to-treat last-observation-carried-forward endpoint scores was used to assess efficacy on Brief Psychiatric Rating Scale (BPRS) and Positive and Negative Syndrome Scale (PANSS) total scores and the 5 factors derived by factor analysis (negative symptoms, positive symptoms, disorganized thoughts, impulsivity/hostility, and anxiety/depression). RESULTS: Olanzapine produced a statistically significantly greater reduction in schizophrenic symptoms than haloperidol (p < .05) on total scores on the BPRS and PANSS on each of the 5 factors as well as on almost all items. Olanzapine induced a response at a rate equal to that induced by haloperidol in the first few weeks, but by the end of the study produced a greater percentage of responders. Compared with haloperidol, olanzapine produced a somewhat greater response on symptoms responsive to haloperidol, but a markedly better response on symptoms unresponsive to haloperidol. This difference favoring olanzapine occurred to an equal degree in all subgroups examined. The incidence of parkinsonism or akathisia following olanzapine treatment was extremely low and not statistically distinguishable from placebo. CONCLUSION: Olanzapine produced a greater improvement than haloperidol particularly by benefiting a much larger number of items or factors. Extrapyramidal side effects and akathisia during olanzapine treatment were statistically indistinguishable from effects seen with placebo.  相似文献   

14.
奥氮平与利培酮治疗难治性精神分裂症的对照研究   总被引:3,自引:0,他引:3  
目的 比较奥氮平与利培酮对难治性精神分裂症的疗效及安全性.方法 68例难治性精神分裂症患者按照排列表法随机分为奥氮平组[34例,(24.1±5.4)mg/d]和利培酮组[34例,(7.9±1.8)mg/d],疗程均为12周.采用阳性和阴性症状量表(PANSS)、临床总体印象量表(CGI)及治疗中需处理的不良反应症状量表(TESS),在治疗前及治疗第1,2,4,8,12周末分别评定疗效和不良反应.结果 (1)奥氮平组PANSS总分、阳性症状分、阴性症状分及一般病理分均从治疗第2周末起较治疗前下降(P<0.05~0.01);利培酮组PANSS总分、阳性症状分、一般病理分从治疗第2周末起,阴性症状分从第4周末起,较治疗前下降(P<0.05~0.01);奥氮平组从治疗第2周末起各时点PANSS总分、阴性症状分均低于利培酮组(P<0.05~0.01).(2)治疗第2周末起,2组临床总体印象量表-严重程度和改善程度(CGI-SI)总分均较治疗前下降(P<0.05~0.01);2组间各时点CGI-SI分的差异无统计学意义(P>0.05).(3)治疗第12周末,奥氮平组、利培酮组临床总有效率分别为65%、41%,差异有统计学意义(P<0.05).(4)奥氮平组、利培酮组不良反应发生率分别为53%(18/34)和59%(20/34),差异无统计学意义(P>0.05);奥氮平组体质量增加发生率高于利培酮组(P<0.05);利培酮组静坐不能、异常泌乳和(或)闭经、肌张力增高的发生率高于奥氮平组(P<0.05).结论 奥氮平对难治性精神分裂症有良好疗效,不良反应轻微.  相似文献   

15.
OBJECTIVE: The aim of this study was to assess effectiveness and tolerability of oral olanzapine treatment of adolescents with schizophrenic disorders. METHOD: Adolescent patients (12-19 years) with schizophrenia, schizoaffective, or schizophreniform disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 4(th) edition (DSM-IV) were enrolled in a multicenter, prospective, open-label study. Following a 2- to 9-day washout period, patients initially received 10 mg/day olanzapine. Dose modification was allowed during week 2 (dose range 5-15 mg/day) and during weeks 3-6 (dose range, 5-20 mg/day). Responders (improvement > or =30% on the Brief Psychiatric Rating Scale, BPRS) continued olanzapine for additional 18 weeks. Psychopathology was assessed using BPRS and Clinical Global Impressions (CGI) scales; side effects were assessed by adverse event reporting. RESULTS: Out of 96 patients enrolled at 10 sites, 60 (62.5%) met response criteria at week 6. Mean BPRS total scores decreased significantly (p < 0.001) from baseline (39.2 +/- 13.4) to week 6 last observation carried forward (LOCF) (22.2 +/- 14.7). The rate of patients considered markedly ill or worse (CGI-S) decreased from 83.3% (baseline) to 37.5% (week 6, LOCF). The most common reported adverse event was weight gain (30.2%, 29/96). Three patients (3.1%) discontinued due to adverse events. CONCLUSIONS: In this study of young patients with schizophrenia, schizoaffective, or schizophreniform disorders, olanzapine treatment was associated with marked symptom improvement. As changes in weight and prolactin levels may be greater in adolescent than in adult patients, potential risks and benefits of olanzapine treatment in adolescents should be considered carefully.  相似文献   

16.
The purpose of this open-label study was to evaluate the use of olanzapine in the treatment of children and adolescents with schizophrenia. Sixteen children who were 8-17 years of age and met DSM-IV criteria for schizophrenia were admitted into a 10-week, open-label, optimizing dose study of olanzapine. The Brief Psychiatric Rating Scale (BPRS), the Positive and Negative Syndrome Scale (PANSS), and the Clinical Global Impression (CGI)-Severity/Improvement scales were used to assess improvement during the study. Of the 16 subjects who completed the study, 12 demonstrated significant improvement on end of treatment BPRS, CGI, and PANSS scores compared with baseline. Male subjects showed greater improvement and also gained more weight. Weight gain occurred in all but 2 subjects. Weight gain was significant, with patients averaging a gain of about 6.2 kg during the 6-week course of the study. Two of the subjects experienced extrapyramidal symptoms. The average dose of olanzapine for all subjects was 0.17 mg/kg.  相似文献   

17.
目的探讨奥氮平治疗精神分裂症的疗效及不良反应。方法将213例精神分裂症患者随机分为研究组(奥氮平治疗)和对照组(氯丙嗪治疗),共治疗8周,治疗前后应用简明精神病评定量表(BPRS)、住院患者观察量表(NOSIE)和副反应量表(TESS)分别评定疗效及不良反应。结果在治疗后的第2周末、第8周末,研究组的BPRS各因子分及总分均低于对照组,差异具有显著性意义(P〈0.05)。在治疗后的第2周末、第8周末,研究组的NOSIE的社会功能、个人整洁、总积极因素因子分及病情总估计分均高于对照组,抑郁、迟缓及总消极因素因子分均低于对照组,差异均具有显著性意义(P〈0.05)。奥氮平组的不良反应少于氯丙嗪组。结论奥氮平可有效改善精神分裂症患者的精神病症状和社会功能。  相似文献   

18.
This study was undertaken to evaluate the efficacy and safety of olanzapine compared with fluphenazine in the treatment of patients who met the Diagnostic and Statistical Manual, fourth edition (DSM-IV) diagnostic criteria for schizophrenia or schizoaffective disorder. This was a long-term (22-week), randomized, double-blind, parallel clinical trial. Sixty patients (mean age, 35.4 years) were randomly assigned to either olanzapine (n=30) or fluphenazine (n=30). They received treatment at three centers in Croatia during a 22-week study period and were assessed weekly for the first 6 weeks and monthly thereafter. Efficacy was measured using the Brief Psychiatric Rating Scale (BPRS), the Positive and Negative Syndrome Rating Scale (PANSS) and the Clinical Global Impression (CGI) Severity and Improvement scores. The Hillside Akathisia Scale (HAS), Simpson-Angus Scale (SAS), Abnormal Involuntary Movement Scale (AIMS), vital signs, laboratory tests, and treatment-emergent adverse events were assessed to evaluate safety. The olanzapine group showed significantly greater mean decreases from baseline to endpoint for BPRS total (-25.8 vs. -16.5, P=.035), PANSS total (-45.7 vs. -29.5, P=.037), PANSS positive (-13.0 vs. -7.9, P=.034), and CGI Severity (-2.2 vs. -1.3, P=.031) scores. The olanzapine group showed greater mean decreases on all measures of extrapyramidal symptoms, significantly so for the SAS (-2.1 vs. 1.9, P=.004) and HAS (-3.4 vs. 2.6, P=.028). Patients in the fluphenazine group experienced a higher incidence of treatment-emergent adverse events (76.7% vs. 50.0%, P=.032). Weight gain was the most frequently reported adverse event in the olanzapine group (16.7% vs. 0.0%, P=.020). Akathisia (30.0% vs. 10.0%, P=.053) and insomnia (20.0% vs. 0.0%, P=.010) appeared most frequent in the fluphenazine group. Daily use of anticholinergics and benzodiazepines were both significantly greater for the fluphenazine group (P=.003 and.04, respectively). No significant changes were observed in vital signs, ECG, or clinical chemistry. The study indicates that olanzapine has advantages in both efficacy and safety compared to fluphenazine; however, the small sample size limits our ability to draw definitive conclusions.  相似文献   

19.
Improved drug therapy for schizophrenia may represent the best strategy for reducing the costs of schizophrenia and the recurrent chronic course of the disease. Olanzapine and risperidone are atypical antipsychotic agents developed to meet this need. We report a multicenter, double-blind, parallel, 30-week study designed to compare the efficacy, safety, and associated resource use for olanzapine and risperidone in Australia and New Zealand. The study sample consisted of 65 patients who met DSM-IV criteria for schizophrenia, schizoaffective disorder, or schizophreniform disorder. Olanzapine-treated patients showed a significantly greater reduction in Positive and Negative Syndrome Scale (PANSS) total, Brief Psychiatric Rating Scale (BPRS) total, and PANSS General Psychopathology scores at endpoint compared to the risperidone-treated patients. Response rates through 30 weeks showed a significantly greater proportion of olanzapine-treated patients had achieved a 20% or greater improvement in their PANSS total score compared to risperidone-treated patients. Olanzapine and risperidone were equivalent in their improvement of PANSS positive and negative scores and Clinical Global Impression-Severity of Illness scale (CGI-S) at endpoint. Using generic and disease-specific measures of quality of life, olanzapine-treated patients showed significant within-group improvement in most measures, and significant differences were observed in favor of olanzapine over risperidone in Quality of Life Scale (QLS) Intrapsychic Foundation and Medical Outcomes Study Short Form 36-item instrument (SF-36) Role Functioning Limitations-Emotional subscale scores. Despite the relatively small sample size, our study suggests that olanzapine has a superior risk:benefit profile compared to risperidone.  相似文献   

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