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661.
662.
RATIONALE: The novel antipsychotic aripiprazole in use for treatment of schizophrenia is a partial agonist at dopamine D2 receptors with actions at a variety of other receptors as well. Cocaine is believed to exert an important part of its rewarding effect by increasing extracellular levels of dopamine that subsequently act at dopamine D2 receptors. OBJECTIVES: As a partial agonist, aripiprazole may antagonize effects at D2 receptors and we accordingly tested whether aripiprazole could antagonize self-administration of cocaine. Because D2-like receptor agonists are self-administered, a D2 receptor partial agonist like aripiprazole might itself be reinforcing. Thus, we also assessed whether mice would acquire self-administration of aripiprazole. MATERIALS AND METHODS: A single session, mouse self-administration procedure was used. RESULTS: Oral pretreatment with aripiprazole dose-dependently decreased cocaine self-administration under a fixed ratio 1 schedule at the peak cocaine dose (0.03 mg/kg/infusion), reaching significance at 0.2 and 0.4 mg/kg of aripiprazole. Using 0.4 mg/kg, aripiprazole decreased rates of cocaine self-administration without shifting the peak of the dose-response function. There was no effect of aripiprazole per se, suggesting that its inhibitory action was due to effects on cocaine self-administration rather than non-specific motor effects. Aripiprazole was not found to be self-administered in the tested dose range (0.0003-0.3 mg/kg/infusion). The three highest doses (0.03, 0.1, and 0.3 mg/kg/infusion) even caused significant decreases in nose-poking activity, possibly due to extrapyramidal side effects. CONCLUSIONS: These data are consistent with a potential role for aripiprazole in treatment of cocaine addiction without abuse potential per se.  相似文献   
663.
Background:  Aripiprazole is an atypical antipsychotic with partial agonist activity at D2 receptors, which could reduce the reinforcing effects of alcohol. The present study examined whether aripiprazole modifies the behavioral and physiological effects of a moderate dose of alcohol in a group of social drinkers.
Methods:  Eighteen healthy subjects (9 men; mean age = 27.6 years) completed a double-blind, within-subject study with 3 experimental sessions in a randomized sequence, during which they received no medication, aripiprazole 2.5 mg, or aripiprazole 10 mg on the day prior to the laboratory session. During the session, subjects consumed alcohol that was served as three standardized drinks (i.e., a total of 0.8 g/kg for men and 0.7 g/kg for women). Breath alcohol concentration (BrAC), heart rate, blood pressure, static ataxia, and subjective effects were measured regularly throughout the laboratory sessions.
Results:  Alcohol consumption produced physiological and subjective responses that were consistent with the literature on its effects. Pre-treatment with aripiprazole was generally well tolerated, with tiredness being the most commonly reported adverse event. The medication was associated with modest physiological effects. It also significantly and dose-dependently increased the sedative effects of alcohol and, to a lesser degree, decreased the euphoric effects of alcohol.
Conclusions:  These findings require replication in a larger subject sample that includes heavy drinkers and in a study that employs a placebo session. Based on its capacity to increase the sedative effects and decrease the euphoric effects of alcohol, aripiprazole could be of value in the treatment of heavy drinking.  相似文献   
664.
目的探讨西酞普兰联合小剂量阿立哌唑治疗躯体形式障碍的疗效。方法将40例服用西酞普兰联合小剂量阿立哌唑患者(简称研究组)与38例单用西酞普兰(简称对照组),从药物的起效时间、症状的改善时间,治疗2、4及6周时SCL-90各因子分、TESS分值,治疗后3个月内服药的依从性及症状的复燃率,以及缓解期采用功能失调性态度问卷(DAS)对两组患者缓解期认知功能进行评定。结果研究组在起效与症状改善时间上均较对照组快;治疗2、4周时两组在躯体化、焦虑、抑郁及偏执分值上有显著差异,而治疗6周时SCL-90除偏执因子分外,两组比较无显著差异;两组在不良反应方面无显著差异,但在治疗的依从性上,研究组能够认识自己疾病并坚持服药的例数却明显高于对照组;研究组3个月内症状的复燃率明显低于对照组;缓解期认知功能比较,研究组DAS评分较对照组明显降低。结论西酞普兰联合小剂量阿立哌唑治疗躯体形式障碍的疗效较单用前者更佳。  相似文献   
665.
目的探讨安脑丸联合阿立哌唑治疗精神分裂症的临床疗效。方法选取2015年4月—2017年4月在河南省洛阳荣康医院进行诊治的精神分裂症患者92例,随机分为对照组(46例)和治疗组(46例)。对照组口服阿立哌唑片,第1周剂量5 mg/d,第2周10 mg/d,之后根据疗效和耐受情况增至15 mg/d维持治疗,1次/d;治疗组在对照组的基础上口服安脑丸,2丸/次,2次/d。两组均治疗6周。观察两组患者临床疗效,比较治疗前后两组患者PANSS、GQOLI-74和PSP评分以及血清学指标。结果治疗后,对照组和治疗组的临床有效率分别为80.43%和95.65%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者PANSS评分显著降低,GQOLI-74和PSP评分显著升高,同组比较差异具有统计学意义(P0.05),且治疗组上述评分明显优于对照组(P0.05)。治疗后,两组患者神经元特异性烯醇化酶(NSE)、S100β蛋白、髓鞘碱性蛋白(MBP)水平均显著降低,胶质源性神经营养因子(GDNF)水平显著升高,同组比较差异具有统计学意义(P0.05),且治疗组上述血清学指标明显优于对照组(P0.05)。结论安脑丸联合阿立哌唑治疗精神分裂症可有效改善患者阳性和阴性症状,改善机体NSE、S100B蛋白、MBP、GDNF水平,具有一定的临床推广应用价值。  相似文献   
666.
目的探讨阿立哌唑联合利培酮对缓解精神分裂症患者暴力行为的影响。方法前瞻性选取2018年3月至2019年12月武汉大学人民医院收治的176例精神分裂症患者为研究对象,根据随机数字表法将样本分为观察组与对照组,每组各88例。观察组予以阿立哌唑、利培酮联合治疗,对照组予以利培酮,2周为1个疗程,共治疗4个疗程。分别在治疗前、治疗后8周采用阳性症状和阴性症状量表(PANSS)评估患者症状改善情况,依据世界卫生组织生存质量测定量表简表(WHOQL-BREF)、韦氏成人智力量表评估生活质量改善情况及认知功能。于治疗前、治疗后2、8周采用《修订版外显攻击行为量表》(MOAS)评估2组患者攻击行为,统计治疗期间的不良反应。结果治疗后8周,观察组阳性症状(12.6±2.7)分,阴性症状(13.5±2.4)分,一般精神病理(21.7±2.6)分,均显著高于对照组[(15.3±2.4)、(15.6±2.3)、(23.5±2.3)分],差异有统计学意义(P<0.05);治疗后8周,2组生活质量评分较治疗前显著提高,观察组心理、社会关系、环境评分依次为(53.2±4.8)、(63.6±5.1)、(56.5±3.4)分,均显著高于对照组[(44.6±3.7)、(58.2±4.6)、(48.4±3.2)分],差异有统计学意义(P<0.05),但2组生理评分比较,差异无统计学意义(P>0.05);治疗后8周,观察组认知功能中言语评分(103.5±14.6)分,与对照组[(99.7±6.5)分]比较,差异无统计学意义(P>0.05),但操作评分(102.7±9.4)分则显著高于对照组[(96.5±7.8)分],差异有统计学意义(P<0.05)。治疗后2周,观察组财产、自身、体力等暴力攻击行为及总评分均显著低于对照组,差异有统计学意义(P<0.05),治疗后8周,观察组各项暴力攻击行为评分均显著低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为2.27%,与对照组不良反应发生率(7.95%)比较,差异无统计学意义(P<0.05)。结论阿立哌唑联合利培酮治疗有助于提高精神分裂症患者生活质量及认知功能,改善其暴力攻击行为。  相似文献   
667.
目的探讨阿立哌唑和利培酮对首发精神分裂症患者记忆功能的影响。方法 112例首发精神分裂症患者随机分成阿立哌唑组和利培酮组,每组56例。在治疗前和治疗12周末采用韦氏记忆量表-第三版的空间广度测验(WMS-ⅢSST)、霍普金斯词汇学习测验-修订版(HVLT-R)、简单视觉空间记忆测验-修订版(BVMT-R)分别对工作记忆、言语记忆和视觉记忆领域进行评定。结果在治疗前,两组的WMS-ⅢSST HVLT-R和BVMT-R得分比较均无统计学意义(P〉0.05)。在治疗12周后,两组的HVLT-R和BVMT-R得分较治疗前比较均有统计学意义(P〈0.05)而治疗后两组间比较无统计学意义(P〉0.05);阿立哌唑组在治疗后的WMS-ⅢSST得分较治疗前显著增加(P〈0.05),且治疗后两组间比较有统计学意义(P〈0.05),而利培酮治疗前后WMS-ⅢSST得分比较无统计学意义(P〉0.05)。结论阿立哌唑和利培酮对首发精神分裂症患者记忆功具有改善作用,阿立哌唑对某些记忆功能改善优于利培酮。  相似文献   
668.
目的观察阿立哌唑治疗女性精神分裂症患者的疗效及安全性和依从性。方法对38例女性精神分裂症患者给予阿立哌唑治疗.疗程8w,采用阳性与阴性症状量表、副作用量表评定临床疗效及不良反应。结果治疗8w末.阿立哌唑有效率为89.5%.不良反应轻.未明显增加体重。结论阿立哌唑治疗女性精神分裂症患者疗效显著.安全性高,依从性好,值得临床推广应用。  相似文献   
669.
Introduction: There has been increasing interest in the use of medications that affect the dopamine receptor in the treatment of alcoholism. Aripiprazole has the unique pharmacology of being a partial dopamine agonist serving to stabilize brain dopamine systems in both frontal cortical and subcortical areas. As such, it might act to dampen alcohol reinforcement and craving and/or alter control over alcohol use. The current clinical laboratory study was conducted to evaluate the safety and efficacy of aripiprazole as a potential agent to alter drinking and objective effects of alcohol. Methods: Thirty nontreatment seeking alcoholics were enrolled in a subacute human laboratory study and received double‐blind treatment with up to 15 mg of aripiprazole (n = 15) or identical placebo (n = 15) for 8 days. Tolerability and utility of aripiprazole was monitored during natural drinking over the first 6 days of medication treatment and also during a free choice limited access alcohol consumption paradigm following an initial drink of alcohol in a bar‐lab setting on Day 8. Results: Aripiprazole was well tolerated and reduced drinking in nontreatment seeking alcoholics over 6 days of natural drinking—especially in those with lower self control (more impulsive). It also reduced drinks in the bar‐lab after a priming drink and broke the link between priming drink induced stimulation and further drinking. During the bar‐lab drinking session, there were no differences in subjective high, intoxication, or craving between subjects treated with aripiprazole or placebo. Discussion: This study joins several others in demonstrating the utility of subacute dosing laboratory paradigms for evaluating medication effects in alcoholics. Aripiprazole was well tolerated and lowered alcohol use, especially in those with lower impulse control. Further study is needed to determine the safety and utility of aripiprazole in the treatment of alcoholism and if subgroups of alcoholics are more likely to respond.  相似文献   
670.
粱映  刘敏东 《内科》2013,(2):118-119,113
目的探讨阿立哌唑联合小剂量氯氮平治疗以阴性症状为主的精神分裂症患者的疗效、安全性及对认知功能的影响。方法将48例以阴性症状为主的慢性精神分裂症患者随机分为研究组和对照组,每组24例。研究组给予阿立哌唑联合小剂量氯氮平治疗,对照组仅给予常规剂量氯氮平治疗,疗程12周;采用阳性与阴性症状量表(PANSS)、治疗中的副反应量表(TESS)评定疗效和副反应,采用威斯康星卡片(WCST)和连续作业测验(CPT)评定患者的认知功能。结果治疗12周后,两组患者PANSS.6-分、三个因子分均低于治疗前(P〈0.05);研究组PANSS总分、一般病理分、阴性症状分低于对照组(P〈0.05);研究组WCST评定总错误数、持续反应数、持续错误数、正确应答数与对照组比较,差异均具有统计学意义(P均〈0.05)。研究组与对照组的CPT评定正确数值、反应时比较差异有统计学意义(P〈0.05),研究组不良反应低于对照组(P〈0.05)。结论阿立哌唑联合小剂量氯氮平治疗以阴性症状为主的慢性精神分裂症患者,可明显改善精神分裂症患者的阴性症状及认知功能;与单用常规剂量氯氮平相比安全性更好。  相似文献   
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