利培酮与氯丙嗪治疗精神分裂症对心电图的影响

目的 :了解和比较利培酮与氯丙嗪对心电图的影响。方法 :对服用利培酮及氯丙嗪的精神分裂症患者分别定期心电图检查 ,时间为服药后 2、4周。结果 :利培酮组和氯丙嗪组出现异常分别为 11.5 %和 4 2 .5 % ,两者有显著性差异 (P <0 .0 5 )。结论 :利培酮对心电图影响明显低于氯丙嗪。     

博思清与维思通治疗精神分裂症对照研究

目的探讨博思清(阿立哌唑)治疗精神分裂症的疗效及副作用。方法用博思清与维思通治疗精神分裂症各20例作为对照研究,采用阳性症状与阴性症状量表(PANSS)、不良反应症状量表(TESS)评定疗效及副作用。结果博思清组有效率86%,显效率78%;维思通组有效率82%,显效率71%。博思清组以兴奋激越等副反应为主,维思通组以锥体外系反应为主。结论该两种药物对治疗精神分裂症均有确切疗效,且安全性相对较高,博思清改善阴性症状效果明显,而维思通对阳性症状的控制更好些。     

认知行为联合药物治疗精神分裂症残留型40例临床研究

目的探讨认知行为治疗精神分裂症残留型的临床效果,为临床治疗提供参考。方法选择2011年1月—2012年8月收治的79例精神分裂症残留型患者作为观察对象,随机将79例患者分成药物治疗组39例与认知行为治疗组40例,药物治疗组患者单纯应用利培酮进行治疗,剂量控制在3～6 mg,平均剂量(4.58±1.19)mg/次,4周为1个疗程,共治疗6个疗程。认知行为治疗组在药物治疗组基础上同时对患者进行认知行为治疗,具体方法如下:选择6名经验丰富的心理治疗师进行个体心理治疗,每周1次,每次治疗时间约60 min,4周为1个疗程,共治疗6个疗程。治疗后通过阳性与阴性症状量表、精神分裂症认知功能量表进行疗效评定。结果治疗后药物治疗组阴性症状分数[(14.3±4.7)分]明显高于认知行为治疗组[(10.8±2.5)分],差异有统计学意义(t=3.863,P<0.05),其他症状比较差异均无统计学意义(均P>0.05)。认知行为治疗组患者治疗后与治疗前相比阴性症状的明显改善,差异有统计学意义(t=4.207,P<0.05)。两组患者阳性症状、一般病理症状及总分比较差异均无统计学意义(均P>0.05)。认知行为治疗组患者后各项分数明显降低,均有统计学意义(均P<0.05);认知行为治疗组患者治疗后各项分数明显低于药物治疗组,均有统计学意义(均P<0.05)。结论认知行为治疗可明显改善精神分裂症残留型患者的阴性症状,且对认知功能有明显的改善,能明显改善患者的社会功能及生活质量,故可作为精神分裂症残留型患者康复的治疗方法。     

齐拉西酮与利培酮治疗首发精神分裂症的疗效和安全性

目的观察齐拉西酮与利培酮对首发精神分裂症患者的治疗效果和不良反应,以更好地为精神分裂症患者进行治疗。方法选择2010年8月-2012年8月广州市脑科医院收治的首发精神病患者64例为研究对象,随机分为两组。对照组给予利培酮治疗,实验组给予齐拉西酮治疗,对比观察两组疗效和不良反应。结果实验组患者经治疗,其PANSS优于对照组患者,组间比较差异有统计学意义(P<0.05);实验组不良反应发生率明显低于对照组(32例患者共发生14例),组间比较差异有统计学意义(P<0.05)。结论使用齐拉西酮对首发精神病患者进行治疗可取得更好的治疗效果,且患者不良反应少,值得临床推广应用。     

Triiodothyronine accelerates and enhances the antipsychotic effect of risperidone in acute schizophrenia

In acute psychotic schizophrenia patients we investigated if the combination of triiodothyronine (T3) plus risperidone was more effective when compared to risperidone monotherapy. Thirty-two in-patients meeting the DSM-IV-TR diagnostic criteria for schizophrenia and without thyroid disease received risperidone (flexibly adjusted dose for tolerability) and were randomized to additionally receive either T3 (25 μg daily; risperidone plus T3 group) or placebo (risperidone plus placebo group). Treatment lasted until meeting the response to treatment criteria defined as score of ≤3 on the Clinical Global Impression Severity and Improvement scales. Acute psychotic episode symptom severity was evaluated using the Brief Psychiatric Rating Scale (BPRS) at treatment initiation and at the final study assessment. Fourteen patients were randomized to receive risperidone plus T3 and eighteen to receive risperidone plus placebo. The time until treatment response was shorter in the risperidone plus T3 group relative to the risperidone plus placebo group (25.5 ± 4.4 days vs 32.2 ± 8.2 days, respectively; p = 0.001). Moreover, there was a greater reduction of BPRS-total score (p = 0.01) in the risperidone plus T3 group relative to the risperidone plus placebo group. Treatment with T3 was associated with shorter time to treatment response (β = −0.440, p = 0.022) and with greater improvement in BPRS score (β = 0.240, p = 0.053), independent of patients' gender, age, baseline BPRS score and mean risperidone dose. The study confirms that addition of T3 to risperidone was associated with accelerated and enhanced treatment response in acutely psychotic schizophrenic patients.     

利培酮联合碳酸锂治疗分裂情感性精神病的疗效分析

目的分析利培酮联合碳酸锂治疗分裂情感性精神病的疗效。方法选取2013年4月~2015年1月我院收治的60例分裂情感性精神病患者,将其按照数字表法分为对照组(n=25)和治疗组(n=35),比较两组患者的治疗效果。结果治疗前后前后的抑郁、燥狂评分比较,P0.05,差异具有统计学意义;对照组患者不良反应的发生率20%高于治疗组的3%,P0.05,差异具有统计学意义。结论利培酮联合碳酸锂治疗分裂情感性精神病能有效的改善患者的抑郁和燥狂情绪。     

奥氮平与利培酮治疗精神分裂症抑郁症状的比较研究

目的:对照比较奥氮平与利培酮对精神分裂症抑郁症状的疗效。方法:66例精神分裂症伴抑郁症状的患者随机分为奥氮平组和利培酮组,各33例,均治疗8周,分别于治疗前和治疗后2、4、6、8周以阳性与阴性症状量表(PANSS)及汉密尔顿抑郁量表(HAMD)评定临床疗效;以治疗中出现的症状量表(TESS)评定不良反应,并体格检查及实验室检查,记录不良事件的发生。结果:治疗后两组患者PANSS和HAMD评分均显著下降,奥氮平组优于利培酮组,两组发生不良反应率无显著差异。结论:奥氮平治疗精神分裂症抑郁症状疗效优于利培酮疗效。     

奥氮平与利培酮治疗冰毒所致精神障碍的疗效

目的 探讨奥氮平与利培酮治疗冰毒所致精神障碍的效果。方法 冰毒所致精神障碍患者100例,采用双盲分组法将其分为观察组与对比组,各50例。对比组患者使用利培酮治疗,观察组患者使用奥氮平治疗,对比分析两组治疗前后阳性和阴性症状量表(PANSS)评分和治疗效果。结果 治疗后,观察组一般精神病理评分(19.52±6.32)分、阴性症状评分(14.42±4.25)分均低于对比组的(25.14±6.54)、(16.98±4.18)分,阳性症状评分(56.28±12.71)分高于对比组的(51.16±11.69)分,差异有统计学意义(P<0.05)。观察组治疗总有效率为94.00%,高于对比组的80.00%,差异有统计学意义(P<0.05)。结论 奥氮平治疗冰毒所致精神障碍效果更佳,具有较好的临床应用价值。     

Impact of self-reported juvenile abuse on treatment outcome in patients with major depressive disorder

Background

We assessed the impact of juvenile abuse (emotional, physical, or sexual) on response to treatment in adults with major depressive disorder (MDD) suboptimally responsive to antidepressant therapy.

Methods

A post hoc analysis explored the relationship between self-reported history of juvenile abuse and response to risperidone or placebo augmentation during a 6-week double-blind study period in patients with MDD suboptimally responsive to a previous adequate trial of antidepressant monotherapy.

Results

Overall, only one clinical measure showed a small, but statistically significant difference in outcome between patients with abuse versus without abuse (HRSD-17). In patients reporting abuse (n=141), improvement with risperidone versus placebo augmentation was greater on several measures: HRSD-17 total and 2 subscale scores, responder rates, Q-LES-Q, and PaRTS-D. In patients without abuse (n=127), only two measures showed significant improvement: HRSD-17 subscale and PaRTS-D. Responder rates (HRSD-17) were: 40.9% (risperidone) versus 23.1% (placebo; p=0.01; odds ratio=2.7) in those with abuse, and 41.0% versus 34.4% (p=0.39; odds ratio=1.4) in those without. Adverse events rates were: 37.0% (risperidone) and 54.4% (placebo) in patients with abuse, and 56.3% and 55.6% in those without.

Limitations

Analysis not preplanned. Validated questionnaire not used to determine abuse status.

Conclusions

Self-reported juvenile abuse history may impact response to risperidone augmentation therapy in adults with MDD suboptimally responsive to antidepressants. Abuse status may reduce placebo response and reporting of adverse events.     

MECT联合利培酮治疗木僵12个月的精神分裂症患者1例

本文报告一例52岁女性精神分裂症患者,病程10余年,木僵12个月,采用改良电休克治疗（MECT）联合小剂量利培酮治疗后,患者木僵逐渐消失,功能逐渐恢复,且病情一直稳定。该病例提示,MECT联合利培酮方案能够使长时间木僵患者达到临床痊愈,并有助于控制精神病性症状。现基于此案例展开讨论,以期为临床相关治疗提供参考。