利培酮和氯氮平对精神分裂症阴性症状的疗效及不良反应比较

目的比较利培酮与氯氮平对精神分裂症阴性症状的疗效和不良反应。方法应用利培酮和氯氮平治疗精神分裂症各２０例，其阴性症状评定量表评分≥６５分者入组。用阴性症状评定量表（ＳＡＮＳ）评定疗效，用副反应量表（ＴＥＳＳ）评定药物不良反应。结果利培酮和氯氮平对精神分裂症阴性症状的疗效相当，起效时间为２周。两药的副反应不同，利培酮多见锥体外系反应，而氯氮平多见心动过速、嗜睡、流涎、便秘等。结论利培酮对精神分裂症阴性症状有效、疗效与氯氮平相当。     

利培酮治疗难治性精神分裂症临床分析

目的：评价对利培酮对难治性精神分裂症的疗效与副作用。方法：对我住院的难治性精神分裂症３０例换用利培酮治疗２４周。用阳性与阴性症状量表（ＰＡＮＳＳ）评定疗效,用副反应量表（ＴＥＳＳ）及锥体外系副反应量表（ＥＳＲＳ）评定副作用。结果：ＰＡＮＳＳ部分、ＰＡＮＳＳ－Ｇ（一般精神病理）分、ＰＡＮＳＳ－Ｐ（阳性症状）分治疗前后有显著差异。ＰＡＮＳＳ总分及各分量表分均自治疗１２周末起有显著下降,说明自第１２周末开始显效。ＰＡＮＳＳ部分减分率≥２０％者１８例,≥５０％者５例,有效率为６０％。最常见的副作用是ＥＰＳ（６／３０）,但症状多较轻。结论：利培酮对难治精神分裂症有肯定的疗效,副反应轻微。     

口服利培酮治疗精神分裂症

为验证利培酮治疗精神分裂症的疗效和安全性，对２０例精神分裂症住院患者给予利培酮４～８ｍｇ／ｄ治疗，疗程８周，以阳性和阴性症状量表（ＰＡＮＳＳ）、大体评定量表（ＧＡＳ）和临床总体印象量表（ＣＧＩ）评定疗效，以锥体外系副反应量表（ＥＳＲＳ）和不良反应量表（ＴＥＳＳ）评定药物不良反应。结果显示，治疗结束时显效率为９０％。利培酮的起效时间在１０天左右，仅有轻度的锥体外系副反应和失眠。提示利培酮对精神分裂症的阳性和阴性症状都有良好的疗效，且安全性较高     

利培酮和氯氮平治疗精神分裂症对照研究

探讨利培酮治疗精神分裂症的疗效，副反应及其作用机理。以利培酮与氯氮平治疗精神分裂症各２０例对照研究，采用ＰＡＮＳＳ、ＥＳＲＳ量表评定疗效及副反应，用ｔ检验、卡方检验进行分析。结果显示，利培酮与氯氮平对治疗精神分裂症均有确切的疗效，而在改善阴性症状方面，利培酮甚至更优于氯氮平，且安全性相对高，病人易于耐受     

氯氮平台并利培酮与氯氮平治疗精神分裂症阴性症状的对照研究

目的 比较氯氮平合并利培酮与氯氮平对精神分裂症阴局限性症状的疗效。方法 ６０例长期住院的精神分裂症患者，分别接受氯氮平合并利培本呼氯氮平治疗，疗程８周，用ＢＰＲＳ，ＳＡＮＳ，ＳＡＰＳ，ＴＥＳＳ评定疗效和副反应。结果 氯氮平合并利培酮组在治疗后４周、８周ＳＡＮＳ评分较治疗前均有显著差异（Ｐ〈０．０１）；氯氮平组在治疗后８周ＳＡＮＳ评分与治疗前比较也有显著差异（Ｐ〈０．０５）。两组在治疗后４周、８周时     

利培酮与氯氮平治疗精神分裂症的对照研究

６０例ＰＡＮＳＳ总分≥６０，符合ＤＳＭ－Ⅳ精神分裂症诊断标准的患者，分别给予利培酮或氯氮平治疗。经８周随机对照研究发现，ＰＡＮＳＳ、ＣＧＩ、ＥＳＲＳ、ＴＥＳＳ量表评定显示，利培酮治疗精神分裂症疗效肯定，有效率９６．７％，与氯氮平相仿。利培酮在治疗１周后起效，阴性症状见效尤早，剂量较小者锥体外系副反应轻，其它不良反应发生率和严重程度较氯氮平明显少而轻，治疗的依从性与生活质量较高。本研究证实，利培酮是     

氯氮平与氯丙嗪治疗精神分裂症的对照研究

为进一步验证氯氮平在治疗精神分裂症中的地位。方法对病程＜５年的１２２例首次住院的精神分裂症患者，采用分层随机法分为两组，分别首选氯氮平和氯丙嗪进行８周治疗。以ＢＰＲＳ、ＳＡＰＳ、ＳＡＮＳ评定疗效，以ＴＥＳＳ评定副反应。结果治疗前后比较，两组ＢＰＲＳ、ＳＡＰＳ分均显著下降（Ｐ＜０．０１），ＳＡＮＳ分氯氮平组显著降低（Ｐ＜０．０１），氯丙嗪组无明显差异（Ｐ＞０．０５）；疗后氯氮平组的ＢＰＲＳ、ＳＡＰＳ、ＳＡＮＳ总分均明显低于氯丙嗪组（Ｐ＜０．０１）；ＴＥＳＳ总分氯氮平组亦低于氯丙嗪组，且无锥体外系副反应。结论氯氮平确是一种十分有效且药物副反应并不多见的抗精神病药。在严密监测血象的情况下，氯氮平实际上可作为一个可供选择的治疗精神分裂症的第一线药使用。     

利培酮与氯丙嗪治疗阳性症状为主 精神分裂症的研究

目的观察利培酮治疗阳性症状为主精神分裂症的疗效及副作用。方法与氯丙嗪对照,疗程１０周,用四级临床疗效、简明精神病评定量表（ＢＰＲＳ）、阳性症状量表（ＳＡＰＳ）评定疗效,用副反应量表（ＴＥＳＳ）观察不良反应。结果利培酮起效时间平均（１０５６±４．２３）天,痊愈率２３８１％,显效率７１４３％,与氯丙嗪组接近;不良反应以锥体外系症状、激越较常见,出现率及严重程度与氯丙嗪组比较无显著性差异（Ｐ＞００５）。结论利培酮对精神分裂症阳性症状的疗效及副作用与氯丙嗪相当     

氯氮平及其联合舒必利治疗精神分裂症的双盲对照研究

目的 比较氯氮平及其联合舒必利治疗精神分裂症的疗效和副反应。方法 ４１例精神分裂症患者,采用随机双盲法进行６周治疗观察,用ＢＰＲＳ、ＳＡＮＳ、临床疗效、ＴＥＳＳ评定疗效和副反应。结果 氯氮平组和氯氮平联合舒必利组ＢＰＲＳ、ＳＡＮＳ评分在治疗末均显著下降（Ｐ〈０．０１）,联合组于疗后３周ＳＡＮＳ７总分即有显著下降（Ｐ〈０．０５）;疗末联合组ＢＰＲＳ、ＳＡＮＳ评分与氯氮平组相比具有显著性差异（Ｐ〈０     

氯氮平对精神分裂症阴性、阳性症状的疗效分析

用氯氮平治疗表现为阴性、阳性症状的精神分裂症病人１３１例，根据阴性症状量表（ＳＡＮＳ）、阳性症状量表（ＳＡＰＳ）评分分为两组，阴性症状组６１例，阳性症状组７０例。分别在治疗前、治疗后２、４、８周使用简明精神病量表、ＳＡＮＳ、ＳＡＰＳ、临床总体印象量表和副反应量表进行盲式评分。结果显示：氯氮平对两组症状均有较好和同等疗效（Ｐ＜０．０１）。对氯氮平的疗效、作用机制、临床应用、副作用及对难治性病例的疗效进行了讨论。     

International multisite double-blind trial of the atypical antipsychotics risperidone and olanzapine in 175 elderly patients with chronic schizophrenia.

OBJECTIVE: The authors compared the effects of the two most commonly used atypical antipsychotics, risperidone and olanzapine, in elderly patients with schizophrenia. METHODS: In an 8-week, international, double-blind study, patients (outpatients, hospital inpatients, and residents of nursing or boarding homes) were randomly assigned to receive risperidone (1 mg to 3 mg/day) or olanzapine (5 mg to 20 mg/day). The main outcome measures were changes in Positive and Negative Syndrome Scale (PANSS) total scores and rates of extrapyramidal symptoms (EPS). RESULTS: Subjects were 175 patients age 60 years or over with schizophrenia or schizoaffective disorder. The mean duration of illness was 36.5 years. Median doses were 2 mg/day of risperidone and 10 mg/day of olanzapine. PANSS total scores and four of the five PANSS factor scores (positive symptoms, negative symptoms, disorganized thoughts, and anxiety/depression) improved significantly at all time-points and at endpoint in both groups; between-treatment differences were not significant. EPS-related adverse events were reported by 9.2% of patients in the risperidone group and 15.9% in the olanzapine group; the between-treatment difference was not significant. Total scores on the Extrapyramidal Symptom Rating Scale were reduced in both groups at endpoint; between-treatment differences were not significant. Clinically relevant weight gain was seen in both groups, but was significantly less frequent in risperidone patients than in olanzapine patients. CONCLUSIONS: Stable elderly patients with chronic schizophrenia receiving appropriate doses of risperidone or olanzapine over an 8-week period experienced significant reductions in the severity of psychotic and extrapyramidal symptoms, with a relatively low risk of side effects.     

氯氮平和利培酮治疗精神分裂症患者比较研究

目的 评价氯氮平和利培酮治疗精神分裂症的疗效和副作用。方法 将40例精神分裂症患者随机分为氯氮平组和利培酮组(氯氮平组20例,利培酮组20例),于治疗前和治疗12周末各作一次韦氏成人智力量表、韦氏记忆量表、威斯康星卡片分类测验、言语流利性测验、连线测验A、简明精神症状评定量表(BPRS)、TESS副反应量表。结果 治疗12周末氯氮平组显著改善BPRS评分,利培酮组显著改善迟滞、思维障碍、敌对猜疑因子分,但氯氮平组较利培酮组敌对猜疑因子分减分率高。两组之间副反应评分有显著性差异,利培酮组明显低于氯氮平组,其余各项无显著性差异。结论 氯氮平较利培酮治疗敌对猜疑效果好,但利培酮较氯氮平副作用小,安全性较高。     

Adverse effects of risperidone and haloperidol treatment in schizophrenia

PURPOSE: Side effects of pharmacological treatment in schizophrenia continue to be a major issue in spite of the development of new antipsychotics. The aim of this study is to explore the adverse effects of conventional and atypical antipsychotic drugs and their associated factors. METHODS: Over 3 months, 41 patients with schizophrenia were randomized to treatment with risperidone 1-12 mg (n=21) or haloperidol 2-20 mg (n=20) daily. Efficacy was assessed by improvement of psychotic symptoms, measured on the Positive and Negative Syndrome Scale (PANSS). The safety and tolerability were assessed with the Extrapyramidal Symptom Rating Scale, the UKU Side-Effect Rating Scale and clinical laboratory assessments. RESULTS: Each treatment reduced psychotic symptoms. PANSS total scores, positive scores, and general psychopathology scores declined as trial went on without significant differences between the two groups. While PANSS negative scores improved better in the risperidone group than in the haloperidol group. The tolerability of antipsychotics was statistical significantly better in the risperidone than in the haloperidol-treated patients. The most frequent adverse effects for both groups were tremor and rigidity. Antipsychotics, their doses, and hyperprolactinemia predict short-term extrapyramidal side effects. Serum prolactin levels could predict parkinsonism and dyskinesia severity. However, dyskinesia was best predicted by the doses of neuroleptics. The predictive factor of dystonia was the antipsychotic drug itself. After adjusting drug doses and concomitant medications, side effects could be markedly improved. CONCLUSIONS: This study suggested that risperidone was superior to haloperidol in improving negative symptoms and better tolerated during the 12 weeks' treatment of schizophrenia. Serum prolactin levels could predict the severity of parkinsonism and dyskinesia.     

利培酮对氯氮平血浓度影响的研究

目的　了解利培酮对氯氮平血浓度的影响及二药合用的疗效与不良反应。方法　对 5 0例原服用氯氮平治疗的难治性精神分裂症患者合并利培酮治疗 ,分别于合并治疗前及后 1月、2月、3月测定氯氮平血浓度 ,同时评定PANSS ,TESS量表。结果　合用利培酮后 ,氯氮平血浓度无明显升高 ,PANSS评分明显降低(P <0 .0 1) ,TESS评分有所增加。结论　利培酮对氯氮平血浓度无明显影响 ,二药合用能增加疗效 ,不良反应有所增加。     

中、小剂量利培酮治疗首发精神分裂症患者的血药浓度与疗效关系的对照研究

目的探讨中、小剂量利培酮治疗精神分裂症患者的血药浓度、临床疗效及不良反应。方法将82例精神分裂症患者随机分为口服利培酮剂量2mg／d组和4nq·g／d组。采用RP—HPLC和LC—MS方法测定利培酮（RSP）和9-羟利培酮（9-OH—RSP）之和的血浆浓度。用阳性和阴性症状量表（PANSS）评定临床疗效,用不艮反应症状量表（TESS）评定不良反应。结果4mg／d组（RSP4-9-OH—RSP）血浓度均显著高于2mg／d组。2rag,／d组第l周末PANSS平均减分率〈20％,其它各周末PANSS平均减分率〉20％,而4mg／d组各周末PANSS平均减分率〉20％．2mg／d组TESS评分明显低于4mg／d组。结论（RSP＋9-OH—RSP）血浓度能较好地反映其临床效应。2mg／d和4mg／d利培酮治疗精神分裂症患者疗效相当,4mg／d利培酮治疗时起效更快,但易发生不良反应。     

奥氮平与氯氮平治疗难治性精神分裂症对照研究

目的评价奥氮平治疗难治性精神分裂症的疗效及安全性。方法将64例难治性精神分裂症患者随机分为研究组和对照组,分别予以奥氮平和氯氮平治疗8周,采用PANSS量表和TESS量表评定疗效和不良反应。结果奥氮平组治疗前后PANSS减分率为39.3%,有效率为72.8%;氯氮平组治疗前后PANSS减分率为36.6%,有效率为59.4%。奥氮平组未见严重的不良反应。结论奥氮平与氯氮平治疗难治性精神分裂症均有良好疗效,奥氮平的副作用小,病人依从性好。     

阿立哌唑和利培酮治疗女性精神分裂症的对照研究

目的以利培酮为对照,探讨阿立哌唑治疗女性精神分裂症的疗效和副作用。方法72例符合CCMD-3诊断标准的精神分裂症病人随机分为两组,分别给予阿立哌唑和利培酮治疗8周。采用阳性症状和阴性症状量表(PANSS)评定临床疗效,副作用量表(TESS)评定副反应。结果治疗8周的疗效相当(P>0．05),阿立哌唑组和利培酮组的显效率分别为81．08％和82．86％,差异无显著性(P> 0．05),阿立哌唑组和副反应(锥体外系、体重增加、月经紊乱)的发生率明显低于利培酮组(P>0．05)。结论阿立哌唑和利培酮对女性精神分裂症的疗效相当,副反应较小。     

迷宫测验与WCST检测利培酮和氯氮平对精神分裂症患者认知功能的影响

目的应用计算机迷宫测验和WCST评估利培酮和氯氮平对精神分裂症患者认知功能的影响。方法63例精神分裂症患者随机分为利培酮组（32例）和氯氮平组（31例），进行双盲给药治疗6周。阳性和阴性症状量表（PANSS）评定临床疗效，计算机迷宫测验和WCST评定认知功能。结果双盲给药的第2周末迷宫测验与WCST成绩呈显著性相关，第6周末仅复杂迷宫测验成绩与WCST中的完成分类数和持续性错误呈非常显著性相关。氯氮平组和利培酮组患者的认知测验成绩均明显改善。阴性症状与认知测验成绩显著相关，而阳性症状的改善与部分认知测验成绩的改善显著相关。结论计算机迷宫测验是一种较好的认知功能评定工具。利培酮和氯氮平均能明显改善精神分裂症患者的认知功能。     

Amisulpride versus risperidone in the treatment of depression in patients with schizophrenia: a randomized, open-label, controlled trial

OBJECTIVE: To determine the effectiveness of amisulpride on depression in patients with schizophrenia, in comparison to risperidone. METHOD: In this open-label, 12-week study, patients with stable schizophrenia and a comorbid major or minor depressive episode (DSM-IV) taking risperidone were randomized into a risperidone-continuation group (N = 45) or an amisulpride-switch group (N = 42). The main outcome measures were changes from baseline on the Calgary Depression Scale for Schizophrenia (CDSS) and the Beck Depression Inventory (BDI). Secondary efficacy measures included the Positive and Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning. Safety measures included treatment-emergent adverse events and extrapyramidal symptoms. RESULTS: The mean dose at endpoint was 4.2 mg/day for risperidone and 458.3 mg/day for amisulpride. Improvements in the CDSS and BDI scores were significantly greater in the amisulpride-switch group than in the risperidone-continuation group at weeks 8 and 12, and at the endpoint. The amisulpride-switch group also showed a significantly greater reduction in the score for the PANSS depression/anxiety factor, and the total score from baseline to endpoint. No significant difference was observed between the two groups for treatment-emergent adverse events or change from baseline for extrapyramidal symptoms. CONCLUSION: Switching from risperidone to amisulpride in patients with stable schizophrenia with comorbid depression improved depressive symptoms significantly compared to continuing with risperidone.     

不同剂量利培酮治疗首发精神分裂症疗效及安全性的比较

目的　探讨利培酮治疗首发精神分裂症的适宜剂量。方法　 12 6例首发精神分裂症患者随机分 4组 (每组 30例 ) ,分别以 2mg/d(2mg组 )、3mg/d(3mg组 )、4mg/d(4mg组 )、5mg/d(5mg组 )利培酮治疗 ,疗程均为 12周。于治疗前及治疗第 1,2 ,4 ,6 ,8,12周末分别进行阳性和阴性症状量表 (PANSS)、临床总体印象量表、治疗中需处理的不良反应量表、锥体外系不良反应量表评分 ,比较 4个组的疗效及不良反应。结果　治疗第 12周末 ,各组PANSS总分减分率在各组间的差异无显著性 ,2mg组阴性症状分低于其他 3组 ,差异有非常显著性 (P <0 0 1)。显效率 :2mg组为 6 7% ,3mg组为87% ,4mg组为 77% ,5mg组为 77% ,各组间差异无显著性。不良反应以锥体外系反应 (EPS)占首位 ,EPS发生率 2mg组为 17% ,3mg组为 6 7% ,4mg组为 93% ,5mg组为 97% ;2 ,3mg组较 4mg、5mg组的EPS发生少且轻 ,差异有非常显著性 (P <0 0 1)。结论　不同剂量利培酮治疗首发精神分裂症的总体疗效的差异无显著性 ,2mg/d对阴性症状群的疗效明显差于 3mg/d、4mg/d、5mg/d。 2mg/d、3mg/d的EPS发生明显少、轻于 4mg/d、5mg/d。利培酮治疗首发精神分裂症的适宜剂量为 3mg/d。