利培酮、氯氮平合并碳酸锂治疗急性躁狂临床对照研究

目的比较利培酮和氯氮平分别合并碳酸锂治疗急性躁狂的疗效和安全性。方法将符合CCMD-3诊断标准的60例各型急性躁狂患者,随机分为两组,在使用碳酸锂的基础上分别联合利培酮或氯氮平进行为期8周的治疗。用躁狂量表(BRMS)及临床疗效总评量表评定疗效,使用副反应量表(TESS)评定副反应。结果利培酮组在治疗第2、4、8周周末显效率分别为18.8%、71.9%和87.5%,有效率为68.8%、87.5%、93.8%,与氯氨平组相似。结论利培酮合并碳酸锂治疗急性躁狂具有与氯氮平合并碳酸锂相似的总体疗效和更高的安全性,可作为急性躁狂治疗的一个选择。

Risperidone or clozapine combined with lithium in treatment of acute mania

Objective To compare the efficacy and safety of risperidone or clozapine both combined with lithium in acute mania. Methods sixty patients with acute mania(CCMD -3) were randomly assigned to receive risperidone or clozapine both combined with lithium for 8 weeks. Treatment efficacy and safety were evaluated with Bech - Rafaelsen mania rating scale (BRMS) and treatment emergent symptom scale (TESS) separately. Results In both groups, total score on BRMS was significantly reduced from baseline, with no significant difference between groups. On the basis of the clinical response criteria (reduction of 30% or more in total BRMS score), more clozapine - treated patients (55.6% ) responded significantly than those assigned to risperidone (28.1% ) at the first weekend. But the study failed to find any significant differences between the two groups after 2, 4and 8 weeks. Conclusion Risperidone combined with lithium was well tolerated and as effective as clozapine plus lithium in acute mania. When antipsychotic is necessary to acute mania, risperidone may be a consideration.