富马酸奎的平对心电图的影响

目的：探讨富马酸奎的平（下称硅的平）引起心电图改善的特征及其与服药时间、剂量之间的关系，并与氯氮平引起的心电图改变作比较。方法：对符合CCMD－3诊断标准的精神分裂症患，在服药前、服药后第2、4、8周分别做心电图检查，记录服药剂量与心电图的改变情况，并在两组之间做显性检验。结果：奎的平引起的心电图改变主要为实性心动过速、T波变化，其程度及发生率均低于氯氮平，一般不影响治疗。并且与服药天数、剂量大小有一定关系。结论：富马酸奎的平可引起心电图改变，但其程度及发生率均低于氯氮平。     

利培酮、氯氮平对精神分裂症患者心电图的影响

目的研究利培酮与氯氮平引起心电图改变对心脏的影响。方法215例精神分裂症患者在服药前、服药后2、4、8周分别作心电图检查。结果服用利培酮、氯氮平后均可引起心电图改变，其中窭性心动过速、心肌缺血均以氯氮平组显著较多。心电图改变与服药时间、药物剂量有关。结论利培酮引起心电图改变显著少于氟氮平，安全性高。不良反应轻微。     

利培酮对儿童心电图的影响

目的：研究利培酮引起儿童心电图改变的特征。方法：对38例儿童精神分裂症患者和86例成人精神分裂症患者，在服药前、服药后2、4、8周分别作心电图检查。结果：利培酮引起儿童心电图改变在窦性心律不齐、室性早搏、Q-T间期延长方面明显高于成人，并与服药剂量有关，与性别、服药时间关系不明显。结论：利培酮引起儿童心电图改变的程度及发生率高于成人，并与剂量有关。     

利培酮对脑电图影响的研究

目的：研究利培酮引起脑电图改变的特征,其改变与用药时间、剂量及疗效之间关系,并与氯氮平引起的脑电图异常作一比较。方法：符合ＣＣＭＤ－２－Ｒ诊断的精神分裂症、分裂样精神病患者入组。在服药前、服药后１周、２周４周分别检查脑电图,产淫药剂量,测定简明精神病评定量表（ＢＰＲＳ）观察疗效。结果：服用利培酮后脑电图波率变慢,服用１周后即出现脑电图异常（Ｐ〈０．０１）,与剂是琢疗效无关,异常率及异常程度轻于氯氮     

奥氮平对脑电图的影响

目的：研究奥氮平引起脑电图改变的特征,及与用药时间,疗效之间的关系。并与氯氮平引起的脑电图异常作比较。方法：符合CCMD－2－R诊断的精神分裂症、分裂样精神病患者,在服药前、服药后1周、2周、4周检测脑电图,用简明精神病评定量表（BPRS）观察其疗效。结果：服用奥氮平后脑电图波率变慢,服用1周后脑电图异常,但与疗效无关,异常率及异常程度均显著低于氯氮平,结论：奥氮平可引起脑电图改变,但程度较轻。     

利培酮与氯氮平治疗精神分裂症对心电图的影响

目的 探讨利培酮、氯氮平分别对心电图的影响。方法 对服用利培酮及氯氮平治疗的精神分裂症病人分别定期心电图检查,时间为服药后第１２、４、８周。结果 利培酮６７次（１２．４１％）,氯氮平３６３次（５９．７０％）出现异常,两者有显著性差异（Ｐ〈０．０５）。结论 利培酮对心电图影响显著低于氯氮平。     

氯丙嗪、氯氮平、利培酮对心电图的影响

目的探讨新型与传统的抗精神病药物在临床治疗中对心电图(ECG)的影响。方法对符合要求的325名入住本院的精神分裂症患者按照所服用的药物分为氯丙嗪等6组,在服药前、服药后1月、服药2月进行定期的心电图检查并进行比较。结果服药后二月ECG之间存在显著性差异;服药2月ECG的药物组间存在显著性差异,氯氮平 利培酮组的异常率最低、氯氮平组最高;单用药组与合并用药组间无统计学差异;性别与药物对ECG的影响因素较大。结论氯丙嗪、氯氮平、利培酮对ECG均有一定程度的影响,用药期间应注意加强ECG检查。     

氯氮平与利培酮对血清脂联素的影响

目的：研究氯氮平与利培酮对血清脂联素（Adi）等代谢的影响。方法：69例精神分裂症患者随机分为氯氮平组和利培酮组。治疗6周测定患者血清Adi，血脂，空腹血糖、胰岛素水平，计算胰岛素抵抗指数（IR），测量身高、体质量，计算体质量指数（BMI），并与36名正常对照者比较。结果：两患者组治疗后的血清Adi明显降低，氯氮平组血清Adi改变与BMI相关；利培酮组血清Adi改变与IR和利培酮剂量相关。结论：氯氮平与利培酮治疗精神分裂症患者可引起血清Adi降低，并与体质量增加、IR、血脂及利培酮剂量密切相关。     

长期服用利培酮、氯氮平及氯丙嗪对精神分裂症患者心电图和心肌酶的影响

目的 了解长期服用抗精神病药物利培酮、氯氮闰及-平氯丙嗪对精神分裂症患者心电图和心几敏酶的影响.方法 选择符合中国精神障碍分类与诊断标准第三版(CCMD-3)精神分裂症诊断标准,且单用研究药物、治疗时间超过五年的患者作为研究对象,共收集217例,其中服用利培酮60例、氯氮平100例、氯丙嗪57例,检测其心肌酶:包括肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶MB亚型(creatine kinase isozyme-MB,CK-MB)、乳酸脱氢酶(lactate dehydrogenase,LDH)和天门冬氨酸氨基转移酶(aspartate aminotransferase,AST),并检测心电图.结果 1、与利培酮组及氯丙嗪组比较,氯氮平组出现心电图异常人数最多,且有统计学差异,其心电图的改变以T波改变及逆钟向转位最为常见;2、心肌酶指标CK-MB在三组患者之间存在统计学差异(P<0.01),其中氯氮平组明显高于利培酮组与氯丙嗪组.结论 长期服用利培酮、氯氮平、氯丙嗪对精神分裂症患者的心肌酶和心电图可产生一定的影响,以氯氮平组变化最为显著.     

利培酮、氯氮平治疗所致心电图改变

了解利培酮与氯氮平引起心电图改变及对心脏的影响。1　对象和方法为 1998～ 2 0 0 1年期间住院病例中随机抽样单独使用利培酮或氯氮平治疗者各 30 0例 ,均符合中国精神疾病分类方案与诊断标准第 2版修订本精神分裂症诊断标准 ;年龄 18～5 6岁 ,平均 (31± 32 )岁 ;病程 1～ 6年 ,平均 3 2年 ;入院胸部透视、化验、心电图及脑电图检查均正常 ;排除心血管疾病。利培酮组女 12 0例 ,男 180例 ,利培酮剂量 2～ 6mg/d。氯氮平组女 138例 ,男 16 2例 ,氯氮平剂量 30 0～ 4 5 0mg/d。疗程4 5～ 6 0天。2　结果利培酮、氯氮平治疗致心电图变化比较…     

Chronic nicotine interactions with clozapine and risperidone and attentional function in rats

Although antipsychotic drugs are therapeutically effective in attenuating the hallmark symptoms of schizophrenia, these improvements do not return most patients to normative standards of cognitive function. Thus, complementary drug treatment may be needed to treat the attentional deficits of schizophrenia as well as to counteract the potential attentional impairments caused by some antipsychotic drugs. Nicotine, a drug commonly self-administered by a great majority of individuals with schizophrenia, has been shown to significantly improve cognitive function in some studies. The current study was conducted to determine the interactive effects of the atypical antipsychotic drugs clozapine and risperidone with chronic nicotine administration on attentional performance. Adult female Sprague-Dawley rats (N=35) were trained to perform an attentional task using an operant visual signal detection task. After training, rats were infused with a dose of 5 mg/kg/day (s.c.) nicotine base (n=18) or saline (n=17) for 28 consecutive days via osmotic pump. In Exp. 1, while being administered chronic nicotine or saline, rats were given acute doses of clozapine (0, 0.625, 1.25 and 2.5 mg/kg, s.c.) and were tested for attentional function. In Exp. 2, while on chronic nicotine or saline, other rats were challenged with acute doses of risperidone (0, 0.025, 0.05 and 0.1 mg/kg, s.c.) and were tested for attentional function. Results showed that acute administration of clozapine caused a significant dose-dependent impairment in choice accuracy (percent hit) in animals treated with chronic saline. Chronic nicotine treatment itself lowered accuracy, but attenuated further declines with acute clozapine treatment. Acute administration of risperidone at high dose significantly reduced performance (percent correct rejection) in chronically saline-treated rats, but in a similar fashion as in Exp. 1, chronic nicotine lowered accuracy but attenuated further impairment with acute risperidone. In summary, atypical antipsychotic drugs clozapine and risperidone significantly impaired choice accuracy in the visual signal detection task. Clozapine was more detrimental than risperidone but the adverse effects of both clozapine and risperidone on attentional performance were masked in rats chronically treated with nicotine.     

Clozapine augmented with risperidone in the treatment of schizophrenia: a randomized, double-blind, placebo-controlled trial

OBJECTIVE: The authors evaluated the efficacy and safety of augmenting clozapine with risperidone in patients with treatment-resistant schizophrenia. METHOD: In a randomized, double-blind, placebo-controlled 12-week trial, 40 patients unresponsive or partially responsive to clozapine monotherapy received a steady dose of clozapine combined with either placebo (N=20) or up to 6 mg/day of risperidone (N=20). Patient psychopathology was assessed at 2-week intervals with the Brief Psychiatric Rating Scale (BPRS) and the Scale for the Assessment of Negative Symptoms (SANS), among other measures. Movement disorders were assessed with the Simpson-Angus Rating Scale. RESULTS: From baseline to week 6 and week 12, mean BPRS total and positive symptom subscale scores were reduced significantly in both groups, but the reductions were significantly greater with clozapine/risperidone treatment. Reductions in SANS scores were also significantly greater with clozapine/risperidone treatment than with clozapine/placebo. The adverse event profile for clozapine/risperidone treatment was similar to that for clozapine/placebo. Simpson-Angus Rating Scale scores were lower with clozapine/risperidone treatment throughout the trial but increased to approach those of clozapine/placebo treatment at week 12. Clozapine/risperidone treatment did not induce additional weight gain, agranulocytosis, or seizures compared with clozapine/placebo treatment. CONCLUSIONS: In patients with a suboptimal response to clozapine, the addition of risperidone improved overall symptoms and positive and negative symptoms of schizophrenia. The combination appears to be safe and well tolerated. Augmentation of clozapine with risperidone may provide additional clinical benefit for patients who are nonresponsive or only partially responsive to clozapine alone.     

Subjective response to clozapine and risperidone treatment in outpatients with schizophrenia

The purpose of the present study was to compare the subjective response and attitude towards antipsychotic treatment between schizophrenic patients receiving clozapine and those receiving risperidone. Ninety-four outpatients who had been on a stable drug dosage were evaluated (clozapine group: n=57, mean dose=254.1 mg/day; risperidone group: n=37, mean dose=3.0 mg/day). Subjective response to antipsychotic treatment was assessed using the Drug Attitude Inventory (DAI). The two treatment groups had a positive total mean score, indicating that both groups had a positive subjective view of drug treatment. The proportion of subjects who had a positive total score was not different between the two groups. In subscale scores, multivariate analysis revealed that clozapine group tended to have a higher score on the subjective positive response subscale (P=0.06). The scores of subjective negative response or attitude to medication subscales were not different between groups. In conclusion, there was no marked difference between stabilized outpatients taking clozapine and risperidone in terms of subjective response and attitude towards antipsychotic treatment. Considering that subjects treated with clozapine were treatment resistant patients, equal DAI score might indicate a more favorable subjective experience of clozapine. Further prospective studies on subjective response to various atypical agents are required to obtain valuable insight into how best to use these drugs from the patient's perspective.     

利培酮与氯氮平对脑电图影响的对照观察

目的研究利培酮与氯氮平对脑电图影响及差异。方法对服用利培酮与氯氮平的各60例患者,分别与治疗前、治疗后2、4、8周进行脑电图检查。结果利培酮组脑电图表现为轻、中度异常,异常率为36.7%,氯氮平组脑电图表现为轻、中、重度异常,异常率为83.3%,两组比较有显著性差异(P<0.01)。结论利培酮对脑电图影响比氯氮平轻。     

Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment

OBJECTIVE: When a schizophrenia patient has an inadequate response to treatment with an antipsychotic drug, it is unclear what other antipsychotic to switch to and when to use clozapine. In this study, the authors compared switching to clozapine with switching to another atypical antipsychotic in patients who had discontinued treatment with a newer atypical antipsychotic in the context of the Clinical Antipsychotic Trials for Interventions Effectiveness (CATIE) investigation. METHOD: Ninety-nine patients who discontinued treatment with olanzapine, quetiapine, risperidone, or ziprasidone in phase 1 or 1B of the trials, primarily because of inadequate efficacy, were randomly assigned to open-label treatment with clozapine (N=49) or blinded treatment with another newer atypical antipsychotic not previously received in the trial (olanzapine [N=19], quetiapine [N=15], or risperidone [N=16]). RESULTS: Time until treatment discontinuation for any reason was significantly longer for clozapine (median=10.5 months) than for quetiapine (median=3.3), or risperidone (median=2.8), but not for olanzapine (median=2.7). Time to discontinuation because of inadequate therapeutic effect was significantly longer for clozapine than for olanzapine, quetiapine, or risperidone. At 3-month assessments, Positive and Negative Syndrome Scale total scores had decreased more in patients treated with clozapine than in patients treated with quetiapine or risperidone but not olanzapine. One patient treated with clozapine developed agranulocytosis, and another developed eosinophilia; both required treatment discontinuation. CONCLUSIONS: For these patients with schizophrenia who prospectively failed to improve with an atypical antipsychotic, clozapine was more effective than switching to another newer atypical antipsychotic. Safety monitoring is necessary to detect and manage clozapine's serious side effects.     

利培酮对精神分裂症患者社会功能的研究

目的:比较利培酮与氯氮平治疗的精神分裂症患者出院后社会功能状况,方法:随机抽取30例服用利培酮,30例服用氯氮平的精神分裂症患者,用阳性症状和阴性症状量表(PANSS), 明精神病评定量表(BPRS),不良反应症状量表(TESS)评定.出院后半年用社会功能缺陷量表(SDSS)评定,并与某些因素进行相关分析及多元逐步回归分析.结果:半年随访发现,服用利培酮的精神分裂症患者在职业工作,婚姻职能,父母职能和社会退缩等社会功能方面明显好于氯氮平,多元逐步回归分析显示,影响社会功能的因素为经济损失多,男性,不能积极参加组织活动,不能与他人和睦相处,BPRS评分高者社会功能差,服用氯氮平的比利培酮差.结论:利培酮和氯氮平相比,治疗的优势主要不在于副反应方面,而在于能较好地改善社会功能.     

利培酮和氯氮平治疗伴抑郁症状的难治性精神分裂症对照研究

目的：比较利培酮和氯氮平对伴抑郁症状的难治性精神分裂症疗效。方法：共70例难治性精神分裂症患者随机服用利培酮和氯氮平治疗。利培酮组34例，氯氮平组36例；伴有抑郁症状者39例，利培酮组17例，氯氮平组22例。治疗12周。分别于治疗前、治疗4、8、12周末采用阳性与阴性症状量表（PANSS），汉密尔顿抑郁量表（HAMD）及功能大体评定量表（GAF）评定疗效。结果：两组PANSS、HAMD和GAF评分在治疗12周均有显著改善；两组间比较差异无显著性。有、无抑郁症状组在治疗4、8、12周末的HAMD总分与治疗前比较均显著减少。结论：抑郁症状不影响难治性精神分裂症的疗效；利培酮和氯氮平对伴抑郁症状的难治性精神分裂症均有效。     

氯氮平、利培酮对心电图QT离散度的影响

目的探讨氯氮平、利培酮对心电图QT离散度(QTd)的影响及QTd对猝死的预防价值。方法取氯氮平、利培酮两研究组和正常对照组各200例,研究组分别于治疗前、治疗后4周测心电图QT间期各一次。结果研究组治疗前的QTd及校正后的QTcd与正常对照组比较均无显著性差异(P>0.05);氯氮平组治疗前、后QTd、QTcd变化的自身比较,均有显著性差异(P<0.01);利培酮组治疗前、后QTd、QTcd变化的自身比较,均无显著性差异(P>0.05)。结论氯氮平对心电图QTd、QTcd有明显的影响,利培酮对心电图QTd、QTcd无明显影响。     

Novel antipsychotics: comparison of weight gain liabilities.

BACKGROUND: We performed a retrospective analysis of 122 clinical records of 92 male patients with DSM-III-R schizophrenia to examine the relative weight gain liabilities of clozapine, risperidone, olanzapine, and sertindole compared with haloperidol. We hypothesized that the unique pharmacodynamic profiles of these agents would contribute to different amounts and patterns of weight gain. METHOD: Data were analyzed to determine differences in weight gain during treatment among patients receiving 5 different drug treatments (clozapine [N = 20], olanzapine [N = 13], risperidone [N = 38], haloperidol [N = 43], and sertindole [N = 8]). Measures of maximal weight gain, final weight, and duration to maximal weight gain were calculated. RESULTS: Repeated measures analyses of variance controlling for age, treatment duration, and initial weight revealed statistically significant differences between groups on all 3 measures. Clozapine and olanzapine had the greatest maximal weight gain liability (F = 4.13, df = 4,23; p = .01). Weight gain with clozapine, but not olanzapine or risperidone, appears to persist (as reflected by final weight) despite behavioral interventions (e.g., nutritional consultation, suggested exercise regimen; F = 5.69, df = 4,23; p = .003). Clozapine- and olanzapine-treated subjects appeared to gain weight over a prolonged period of time, whereas risperidone-and sertindole-treated subjects had a more limited period of weight gain (F = 2.95, df = 4,25; p = .04). CONCLUSION: Clozapine and olanzapine caused the most weight gain, risperidone was intermediate, and sertindole had less associated weight gain than haloperidol. The relative receptor affinities of the novel antipsychotics for histamine H1 appear to be the most robust correlate of these clinical findings.