阿立哌唑治疗难治性精神分裂症的疗效观察

目的观察阿立哌唑治疗难治性精神分裂症的疗效及不良反应。方法48例难治性精神分裂症患者,随机分为两组,分别给予阿立哌唑与氯氮平治疗,疗程8周。采用阳性与阴性症状量表(PANSS)、副反应量表(TESS)评定疗效及不良反应。结果阿立哌唑组显效率为65．4%,氯氮平组显效率为68．2%。氯氮平药物副反应明显高于阿立哌唑组。结论对难治性精神分裂症阿立哌唑疗效与氯氮平相似,但副反应少。     

阿立哌唑与氯氮平对精神分裂症患者生活质量影响的对照研究

目的探讨阿立哌唑对精神分裂症患者生活质量的影响。方法对90例精神分裂症患者随机分为两组，分别给予阿立哌唑、氯氮平治疗6个月。用阳性症状与阴性症状量表（PANSS）评定精神症状，用世界卫生组织编制的生活质量量表（WHO QOL-100）评定生活质量，用TESS评定药物不良反应。结果治疗6个月后，两组对患者的生活质量均有改善。阿立哌唑组对WHO QOL-100各领域中，除精神支柱领域外，在生理、心理、独立性、社会关系和环境等领域的改善均明显优于氯氮平组；而氯氮平组仅明显改善心理领域。两组PANSS总分较疗前均有极显著性差异（P〈0．01），两组间比较无显著性差异，但阿立哌唑对阴性症状的改善优于氯氮平。阿立哌唑比氯氮平的不良反应少且轻。结论阿立哌唑对精神分裂症患者生活质量的改善优于氯氮平，有利于患者重返社会。     

Aripiprazole blocks reinstatement of cocaine seeking in an animal model of relapse.

BACKGROUND: Aripiprazole (Abilify) is an atypical antipsychotic drug primarily characterized by partial agonist activity at dopamine (DA) D2 receptors and low side effects. Based on pharmacologic properties that include a stabilization of mesocorticolimbic DA activity, a pathway implicated in addiction, aripiprazole was tested for its ability to prevent relapse to cocaine seeking in rats. METHODS: We assessed the dose-dependent effects of aripiprazole on conditioned cue-induced and cocaine-primed reinstatement of drug-seeking behavior following chronic intravenous cocaine self-administration in an animal model of relapse. RESULTS: Aripiprazole potently and dose-dependently attenuated responding on the previously cocaine-paired lever during both reinstatement conditions, with slightly greater efficacy at reducing conditioned-cued reinstatement. Aripiprazole was effective at doses that failed to alter cocaine self-administration, food self-administration, reinstatement of food-seeking behavior, or basal locomotor activity, suggesting selective effects of aripiprazole on motivated drug-seeking behavior. CONCLUSIONS: These results in a relapse model show that aripiprazole can block cocaine seeking without affecting other behaviors. The D2 partial agonist properties of aripiprazole likely account for the blockade of reinstatement of cocaine-seeking behavior. Given its established efficacy and tolerability as a treatment for psychosis, aripiprazole may be an excellent therapeutic choice for reducing craving and preventing relapse in people with cocaine dependency.     

阿立哌唑与氯氮平治疗首发精神分裂症对照研究

目的比较阿立哌唑与氯氮平治疗首发精神分裂症的疗效及安全性。方法将63例首发精神分裂症患者随机分为阿立哌唑组(n=32)和氯氮平组(n=31)进行治疗,疗程8周。采用PANSS量表和TESS量表评定疗效和不良反应。结果两组疗效差异无显著性(P>0.05),阿立哌唑不良反应显著少于氯氮平(P<0.01)。结论阿立哌唑与氯氮平治疗首发精神分裂症均有效,前者不良反应少,安全性高。     

阿立哌唑与利培酮治疗精神分裂症的对照研究

目的 比较阿立哌唑与利培酮治疗精神分裂症的疗效.方法 60例符合CCMD-3精神分裂症患者分为两组各30例,分别予阿立哌唑(A组)和利培酮(B组)治疗6周,采用阳性症状与阴性症状量表及不良反应症状量表评定疗效与副反应.结果 两组疗效及不良反应发生率比较差异无显著性意义.结论 阿立哌唑和利培酮对精神分裂症疗效相当,副反应差异亦不显著;但在锥体外系反应,内分泌改变及体重增加方面,阿立哌唑优于利培酮.     

齐拉西酮与阿立哌唑治疗以阴性症状为主的精神分裂症对照研究

目的比较齐拉西酮与阿立哌唑治疗以阴性症状为主的精神分裂症的疗效和安全性。方法将66例以阴性症状为主的精神分裂症患者随机分为研究组（齐拉西酮治疗）和对照组（阿立哌唑治疗）,采用阳性和阴性症状量表（PANSS）、阴性症状评定量表（SANS）评定疗效,副反应量表（TESS）评定不良反应。结果治疗8周后,齐拉西酮组痊愈率33.3%,显效率81.8%。阿立哌唑组痊愈率27.3%,显效率78.8%。齐拉西酮组总不良反应发生率为42.4%,阿立哌唑组总不良反应发生率为57.6%。结果显示两组在疗效和不良反应发生率方面差异均无显著性（P〉0.05%）。结论齐拉西酮与阿立哌唑治疗以阴性症状为主的精神分裂症疗效相当,不良反应轻微,两种药物均有疗效好、安全性高的特点。     

阿立哌唑与利培酮治疗慢性精神分裂症的对照研究

目的 探讨阿立哌唑与利培酮治疗慢性精神分裂症的疗效及安全性。方法 对50例慢性精神分裂症患者随机分为2组，分别给予阿立哌唑和利培酮治疗8周，采用阳性与阴性症状量表（PANSS）及副反应量表（TESS）在治疗前后1、2、4、8周末分别评定疗效和副反应。结果 阿立哌唑组和利培酮组疗效间无显著性差异。TESS评定阿立哌唑组副作用小于利培酮组（P〈0．01）。结论 阿立哌唑与利培酮对慢性精神分裂症均有较好的疗效。阿立哌唑具有较小的副作用。     

老年精神分裂症患者采用阿立哌唑与喹硫平治疗对其PANSS评分及不良反应发生率的影响

目的 分析阿立哌唑与喹硫平治疗老年精神分裂症患者的效果.方法 随机选择2015年1月至2016年1月在本院接受治疗的老年精神分裂症患者60例参与研究,随机平均分成两组,对照组利用喹硫平对患者进行治疗,观察组选择阿立哌唑对患者进行治疗,比较两组治疗前后PANSS评分变化情况以及不良反应发生情况.结果 两组治疗后PANSS评分较治疗前均有明显下降,但组间差距不明显;观察组治疗总有效率为83.33％,对照组为76.67％;两组治疗后生活质量较治疗前均有明显上升,但组间差距不明显;观察组不良反应发生率为13.33％,对照组为26.67％,两组不良反应发生率比较差异有统计学意义.结论 阿立哌唑与喹硫平在老年精神分裂症患者的治疗中都有较好疗效,但是相对于喹硫平,阿立哌唑能够减少不良反应,提高治疗安全性,值得推广.     

Effects of lithium and aripiprazole on brain stimulation reward and neuroplasticity markers in the limbic forebrain

Bipolar disorder (BD) is a severe pathological condition with impaired reward-related processing. The present study was designed to assess the effects of two commonly used BD medications, the mood stabilizer lithium chloride (LiCl) and the atypical antipsychotic and antimanic agent aripiprazole, in an animal model of reward and motivation and on markers of neuroplasticity in the limbic forebrain in rats. We utilized intracranial self-simulation (ICSS) to assess the effects of acute and chronic administration of LiCl and aripiprazole on brain stimulation reward, and phosphorylation studies to determine their effects on specific cellular neuroplasticity markers, i.e., the phosphorylation of CREB and crucial phosphorylation sites on the GluA1 subunit of AMPA receptors and the NA1 and NA2B subunits of NMDA receptors, in the limbic forebrain. Chronic LiCl induced tolerance to the anhedonic effect of the drug observed after acute administration, while chronic aripiprazole induced a sustained anhedonic effect. These distinct behavioral responses might be related to differences in molecular markers of neuroplasticity. Accordingly, we demonstrated that chronic LiCl, but not aripiprazole, decreased phosphorylation of CREB at the Ser133 site and NA1 at the Ser896 site in the prefrontal cortex and GluA1 at the Ser831 site and NA2B at the Ser1303 site in the ventral striatum. The present study provides evidence for BD medication-evoked changes in reward and motivation processes and in specific markers of neuronal plasticity in the limbic forebrain, promoting the notion that these drugs may blunt dysregulated reward processes in BD by counteracting neuronal plasticity deficits.     

阿立哌唑对抗精神病药物所致的老年精神分裂症患者高催乳素血症的影响分析

目的：探讨阿立哌唑对抗精神病药物所致的老年精神分裂症患者高催乳素血症的影响。方法根据治疗方法对该院于2012年5月-2014年10月收治的患者进行分组,两组患者均继续沿用原有抗精神病药物,在此基础上给予观察组患者阿立哌唑。分别测定两组治疗前、治疗4、8周末血清催乳素水平,同时采用精神病评定量表(BPRS)对精神病症状进行评定,比较两组药物不良反应。结果观察组患者治疗4周、8周末血清催乳素水平显著降低,与对照组比较,差异有统计学意义(P<0.05);两组治疗前后BPRS评分差异无统计学意义(P>0.05);两组患者药物不良反应发生率差异无统计学意义(P>0.05)。结论阿立哌唑能够有效降低抗精神病药物所致的老年精神分裂症患者高催乳素血症状,且未出现严重药物不良反应,具有有效性和安全性,可作为治疗用药。