帕罗西汀对首发精神分裂症患者认知功能的影响

目的 观察帕罗西汀对首发精神分裂症患者认知功能的影响。方法采用随机、双盲对照法,将120例首发精神分裂症患者平均分为研究组(帕罗西汀+奋乃静)和观察组(奋乃静+安慰剂)。在治疗前,治疗后4、8、12周末分别以阳性症状和阴性症状量表(PNASS)和副反应量表(TESS)评定疗效和副作用,韦氏记忆量表(WMS)评定治疗前后患者认知功能的改变。结果治疗12周后,研究组的韦氏记忆量表的再认、联想及记忆商(MQ)为:9.8±2.1、10.4±1.9、104.6±13.8;观察组分别为9.3±2.0、9.2±2.5、92.8±14.9,两组有显著差异(P<0.05)。PANSS总分、阴性因子分及一般精神病理症状分比治疗前明显降低,治疗后4、8、12周末TESS评分,研究组均低于观察组,且治疗后低于治疗前,均有显著性差异(P<0.05)。结论帕罗西汀对首发精神分裂症患者认知功能有明显改善,且副作用减少。     

度洛西汀对首发精神分裂症患者认知功能的影响

目的 观察度洛西汀对首发精神分裂症患者认知功能的影响.方法 采用随机、双盲对照法,将120例首发精神分裂症患者平均分为研究组(度洛西汀+奋乃静)和观察组(奋乃静+安慰剂).在治疗前,治疗后4、8、12周末分别以阳性症状和阴性症状量表(PNASS)和副反应量表(TESS)评定疗效和副作用,韦氏记忆量表(WMS)评定治疗前后患者认知功能的改变.结果 治疗12周后,研究组的韦氏记忆量表的再认、联想及记忆商(MQ)为:(10.4±2.1)、(11.4±1.9)、(103.6±13.8);观察组分别为(8.9±2.8)、(9.4±2.5)、(91.8±14.9),两组有显著差异(P<0.05).PANSS总分、阴性因子分及一般精神病理症状分比治疗前明显降低,治疗后4、8、12周末TESS评分,研究组均低于观察组,且治疗后低于治疗前,均有显著性差异(P<0.05).结论 度洛西汀对首发精神分裂症患者认知功能有明显改善,且副作用减少.     

氟西汀合并奥氮平治疗精神分裂症对照研究

目的:观察氟西汀合并奥氮平治疗精神分裂症阴性症状的疗效和不良反应.方法:对47例慢性精神分裂症患者随机分为两组:氟西汀加奥氮平研究组(n=23)和奥氮平对照组(n=24),于治疗前和治疗后2、4、8、12周末利用PANSS和TESS进行疗效及不良反应评价.结果:治疗4周后研究组总分及阴性因子分比治疗前明显降低,且阴性因子及焦虑/抑郁因子分值显著低于对照组,体质量增加明显低于对照组.结论:氟西汀合并奥氮平能明显改善精神分裂症患者的阴性症状及焦虑/抑郁症状,不良反应少.     

喹硫平和氟哌啶醇治疗首发精神分裂症对比研究

目的比较喹硫平和氟哌啶醇治疗首发精神分裂症的疗效和安全性。方法将首发精神分裂症患者60例随机分为2组,各30例,分别单用喹硫平和氟哌啶醇进行8周治疗,采用阳性和阴性症状量表（PANSS）、不良反应量表（TESS）于治疗前、治疗2周、4周和8周末评定疗效和不良反应。结果2组治疗后2周、4周、8周PANSS总分及各因子分与治疗前比较均有显著性差异（P〈0.05或P〈0.01）;第8周末喹硫平组PANSS总分及阴性症状因子分较氟哌啶醇组显著降低（P〈0.05或P〈0.01）。喹硫平组不良反应发生率显著低于氟哌啶醇组（P〈0.01）。结论喹硫平对精神分裂症阴性症状疗效优于氟哌啶醇,且不良反应较轻。     

拉莫三嗪对难治性精神分裂症患者认知功能的影响

目的探讨拉莫三嗪对难治性精神分裂症患者认知功能的影响。方法采用入院顺序分层随机法,将80例难治性精神分裂症患者平均分为研究组(拉莫三嗪+利培酮)和对照组(利培酮+安慰剂)。在治疗前和治疗后2、4、8、12周末,用阳性症状及阴性症状量表(PANSS),不良反应量表(TESS)评定疗效及副反应,用韦氏成人智力量表(WAIS-R)、韦氏记忆量表(WMS)评定治疗前后患者认知功能的改变。分析量表中各领域的计分。结果两组PANSS总分在治疗后与治疗前比较差异存在统计学意义(P<0.05),研究组有效率72.5%,显效率20%;对照组有效率52.5%,显效率12.5%。两组间疗效差异有统计学意义(P<0.05),且两组言语量表、操作量表、全量表和记忆量表分比治疗前明显提高,研究组与对照组比较差异有统计学意义(P<0.05)。治疗后2、4、8、12周末TESS评分,两组差异无统计学意义(P>0.05)。结论拉莫三嗪合并利培酮治疗难治性精神分裂症疗效确切,且安全性高,对认知功能的改善彻底。     

瑞波西汀与氟西汀治疗抑郁症随机双盲多中心临床研究

目的:评价瑞波西汀治疗抑郁症的疗效和安全性。方法:采用随机、双盲双模拟、氟西汀平行对照、剂量固定的多中心研究。受试者分别口服瑞波西汀胶囊8mg·d-1或氟西汀片20mg·d-1。采用汉密尔顿抑郁量表(HAMD)总分减分值作为主要疗效指标,以临床总体印象量表(CGI)和汉密尔顿焦虑量表(HAMA)评分作为次要疗效指标;采用药物不良反应量表(TESS)、实验室检查、生命体征等观察药物安全性。结果:共收集符合意向治疗抑郁症病人(ITT)222例,瑞波西汀组(试验组)109例,氟西汀组(对照组)113例。符合研究方案病人(PP)213例,瑞波西汀组104例,氟西汀组109例。治疗6wk后,瑞波西汀组HAMD总分减分值为(16±s7)分,氟西汀组为(16±7)分,与治疗基线相比差异均有非常显著意义(P<0.01),但2组相比差异无显著意义(P>0.05);瑞波西汀组有效率(HAMD减分率≥50%)为81.7%,氟西汀组为77.9%,2组相比差异无显著意义(P>0.05);瑞波西汀组临床治愈率(HAMD总分≤8)为62.4%,氟西汀组为58.4%,2组差异无显著意义(P>0.05);在CGI,HAMA评分上,2组差异亦无显著意义。安全性分析显示,2组不良反应的症状和发生率相比差异均无显著意义。结论:瑞波西汀治疗抑郁症安全有效。     

国产奎硫平联合用药对难治性抑郁症的疗效及认知功能的影响

目的观察国产奎硫平联合用药对难治性抑郁症的疗效及认知功能的影响。方法采用入院顺序分层随机法,将80例难治性抑郁症患者平均分为研究组（奎硫平＋丙米嗪）和对照组（丙米嗪＋安慰剂）,在治疗前和治疗后第4、8、12周末分别用汉密尔顿抑郁量表（HAMD）、副反应量表（TESS）评定疗效和不良反应,韦氏记忆量表（WMS）评定治疗前后患者认知功能的改变。结果治疗12周后,研究组的韦氏记忆量表的再认、联想及记忆商（MQ）分别为：9.9±2.4,10.9±2.1,101.9±12.7;观察组分别为9.2±2.6,8.9±2.1,90.3±13.5,两组差异有统计学意义（P〈0.05）。研究组HAMD总分及各因子分比治疗前明显降低,且治疗因子分显著低于对照组,治疗后第4、8、12周末TESS评分,第4周末研究组高于对照组,第8、12周末两组差异无统计学意义。结论国产奎硫平对难治性抑郁症的疗效确切,对认知功能有一定的改善。     

奥氮平与氟哌啶醇对精神分裂症认知功能影响的对照研究

目的 探讨奥氮平与氟哌啶醇对首发精神分裂症患者认知功能的影响.方法 50例首发精神分裂症患者随机分为治疗组(奥氮平,n =25)和对照组(氟哌啶醇,n =25),在治疗前和治疗8周末进行阳性和阴性症状量表(PANSS )、临床疗效总评量表(CGI)和威斯康星卡片分类测验(WCST)等神经心理测验,观察两种药物对认知功能...     

齐拉西酮合并低剂量氟哌啶醇治疗精神分裂症顽固性幻听的临床疗效

目的 观察齐拉西酮合并低剂量氟哌啶醇治疗精神分裂症顽固性幻听症状的临床疗效和安全性,并探讨其作用机制。方法 符合纳入标准的60例患者随机分为观察组和对照组,每组30例,对照组单用抗精神病药齐拉西酮治疗,观察组以齐拉西酮合并低剂量氟哌啶醇进行治疗。于治疗前及治疗后2周末、4周末、8周末、12周末分别采用阳性和阴性症状量表(PANSS)、幻听量表(AHRS)治疗前后各次的减分率评定疗效,副反应量表(TESS)评定疗效及不良反应,疗程12周。结果 治疗前,观察组和对照组PANSS总分及各分量表得分、AHRS评分的组间差异均无显著性;治疗后,2组间PANSS总分及阴性量表评分、一般病理评分比较无显著性差异,但2组在阳性量表评分及AHRS评分的比较有显著性差异(P<0.01)。结论 齐拉西酮合并低剂量氟哌啶醇治疗精神分裂症顽固性幻听的效果充分显现,不良反应轻微,治疗依从性高,可作为临床治疗精神分裂症顽固性幻听的方法之一。     

甲磺酸瑞波西汀治疗抑郁症的疗效与安全性

目的:评价瑞波西汀治疗抑郁症的有效性和安全性。方法:73例抑郁症患者随机分成2组,治疗组为36例,给予甲磺酸瑞波西汀胶囊8~12mg.d-1;对照组37例,给予氟西汀胶囊20~40mg.d-1,2组疗程均为6周,治疗前及治疗后1、2、4、6周末采用HAMD、HAMA及TESS量表评定临床疗效和不良反应。结果:2组治疗结束时HAMD与HAMA评分均有显著下降(P<0.01),治疗组显效率为69.4%,对照组显效率为67.6%,2组疗效及不良反应比较无显著性差异(P>0.05)。结论:瑞波西汀与氟西汀治疗抑郁症的疗效和不良反应相似,是一种安全、有效的抗抑郁药。     

甲磺酸瑞波西汀联合西沙必利治疗功能性消化不良的疗效观察

目的:观察甲磺酸瑞波西汀联合西沙必利治疗功能性消化不良的疗效。方法:146例功能性消化不良患者随机分成2组。治疗组76例,给予甲磺酸瑞波西汀胶囊联合西沙必利片治疗;对照组70例,给予西沙必利片治疗。疗程均为4周。结果:治疗组与对照组的总有效率分别为84.21%、61.43%,差异有统计学意义(P<0.05);治疗结束8周后随防,治疗组与对照组的复发率分别为12.50%、30.23%,差异有统计学意义(P<0.05)。结论:甲磺酸瑞波西汀联合西沙必利治疗功能性消化不良疗效好。     

瑞波西汀治疗老年抑郁症的临床观察

目的：评价瑞波西汀治疗首发老年抑郁症的疗效和安全性。方法：采用随机、单盲、平行对照方法。受试者分别口服瑞波西汀胶囊8 mg.d^-1或帕罗西汀片20 mg.d^-1。采用HAMD、HAMA（汉密尔顿抑郁、焦虑量表）总分减分率以及CG1分作为主要疗效指标;实验室检查、生命体征等观察药物安全性。结果：共收集符合入组标准的患者80例,瑞波西汀组（试验组）与帕罗西汀组（对照组）各40例。治疗42 d后,瑞波西汀组HAMD、HAMA总分明显下降,与治疗基线相比均有显著性差异（P〈0.01）,但两组间相比差异无统计学意义（P〉0.05）;瑞波西汀组有效率（HAMD减分率≥50%）为82.5%,帕罗西汀组为77.5%,两组间相比差异无统计学意义（P〉0.05）;瑞波西汀组临床治愈率（HAMD、HAMA总分≤8）为62.5%,帕罗西汀组为55.0%,两组间差异无统计学意义（P〉0.05）;在CGI评分上,两组间差异亦无统计学意义。安全性分析显示：两组不良反应的症状和发生率相比差异均无统计学意义。结论：瑞波西汀治疗首发老年抑郁症安全有效,不良反应较少。     

Reboxetine: a review of efficacy and tolerability

Clinical data on the efficacy and tolerability of the novel selective noradrenergic reuptake inhibitor reboxetine are reviewed. Reboxetine appears to have almost no pharmacological activity other than potently blocking the reuptake of noradrenaline. Clinical studies show reboxetine to be highly effective for the treatment of major depression. Reboxetine is more effective than placebo and comparable in efficacy to tricyclic antidepressants and selective serotonin reuptake inhibitors. Some studies suggest that reboxetine may have slightly better efficacy than fluoxetine and imipramine. Reboxetine is effective in severely depressed patients as well as elderly depressed persons. Reboxetine is remarkably well tolerated, having very few side effects. Reboxetine appears to cause little sexual dysfunction. The most common side effects are dry mouth and constipation. The drug does not inhibit or induce hepatic cytochrome P450 enzymes and is safe in overdose. Reboxetine may prove to be as effective and better tolerated than any other antidepressant currently available.     

Reboxetine,a selective noradrenaline reuptake inhibitor for the treatment of depression

Reboxetine is a selective noradrenaline reuptake inhibitor that has been found to be efficacious and tolerable in both short- and long-term treatment of depression. It is a racemic mixture of two enantiomers, the (S,S)-enantiomer being the more potent inhibitor. Reboxetine has little effect on 5-HT or dopamine reuptake, does not inhibit monoamine oxidase activity and has low affinity for alpha-adrenergic and muscarinic receptors. Absorption is rapid and the terminal elimination half-life (13 h) allows twice-daily administration. It shows linear pharmacokinetics which are unaffected by multiple dosing, gender or hepatic insufficiency, although doses should be reduced in elderly patients and in those with severe renal impairment. Reboxetine does not interact with the principal isotypes of the cytochrome P450 system and should have a low potential for drug-drug interactions. Studies in animal models indicate that it has low toxicity.     

齐拉西酮与氟哌啶醇治疗精神分裂症的对照研究

目的探讨齐拉西酮与氟哌啶醇治疗精神分裂症的疗效和安全性。方法将94例符合CCMD-3诊断标准的精神分裂症患者随机分为两组,分别给予齐拉西酮和氟哌啶醇治疗8周。分别于治疗前和治疗后2、4、6、8周末采用阳性症状和阴性症状量表(PANSS)评定临床疗效,副反应量表(TESS)评定副反应。结果治疗8周后,两组疗效近似(P>0.05),齐拉西酮组和氟哌啶醇组的有效率无显著性差异;齐拉西酮组的副反应发生率低于氟哌啶醇组,但无显著性差异。氟哌啶醇组锥体外系副反应明显高于齐拉西酮组(P<0.05)。结论齐拉西酮与氟哌啶醇对精神分裂症患者的疗效相当,副作用较小。     

Effects of reboxetine on Hamilton Depression Rating Scale factors from randomized, placebo-controlled trials in major depression

Reboxetine is the first selective norepinephrine reuptake inhibitor (NRI) approved for the treatment of major depressive disorder (MDD). Although reboxetine has demonstrated efficacy for the treatment of depression, its effects on specific depressive symptoms have not been reported. We evaluated the effects of reboxetine on four Hamilton Depression Rating Scale (HAM-D) factors: psychomotor retardation, anxiety, cognitive disturbance and insomnia. Data were obtained from four short-term (4-8-week), randomized, placebo-controlled trials of reboxetine for the treatment of MDD. For each study, mean changes in HAM-D symptom factor scores from randomization to the study endpoint were compared between reboxetine and placebo. In addition, data from all four studies were pooled to determine the proportions of patients who either improved or worsened with treatment were compared between placebo (n = 353) and reboxetine (n = 350) treatment groups. Compared to placebo, reboxetine significantly improved psychomotor retardation in all four trials. Cognitive disturbance and anxiety were improved in three of four trials, and insomnia was improved in one trial with a positive trend in the second trial. Reboxetine, a selective NRI, improves symptoms of psychomotor retardation, anxiety and cognitive disturbance during treatment of MDD.     

小儿安神补脑颗粒治疗小儿多发性抽动症60例临床研究

目的探讨小儿安神补脑颗粒治疗小儿多发性抽动症的临床疗效,为治疗本病提供新的中成药制剂。方法将符合诊断标准的100例患儿随机分为治疗组60例,对照组40例。治疗组采用小儿安神补脑颗粒进行治疗;对照组服用氟哌啶醇片进行治疗。两组均以3月为1个疗程,共治疗2个疗程。观察两组治疗前后抽动症状次数、频率、强度、复杂性、干扰、损害等分数变化,用耶鲁综合抽动严重程度量表进行评定。结果1.治疗组在运动性抽动、发声性抽动、治疗后总疗效等方面均优于对照组,两组比较差异有统计意义(P0.05)。2.治疗组远期疗效好、不良反应少,与对照组比较差异有统计意义(P0.05)。3.治疗组治疗病程1年以内的患儿疗效最佳。结论小儿安神补脑颗粒对多发性抽动症患儿有显著的治疗作用。     

Haloperidol treatments increased macrophage activity in male and female rats: influence of corticosterone and prolactin serum levels.

Haloperidol is a receptor D2 antagonist frequently used in the treatment of schizophrenic patients. Haloperidol increased prolactin release from anterior pituitary gland, and prolactin modulates immune system activity. Groups of six male and female rats received an acute 2 mg/kg haloperidol treatment (E1), or a long-term (E2) haloperidol treatments (2 mg/kg/day for 21 days); control rats were treated similarly, but with control solution (groups C1 and C2, respectively). In this work long-term haloperidol treatment (E2) increased macrophage spreading, phagocytosis and NO release in male and female rats. However, acute haloperidol treatment (E1) did not change macrophage activity. Corticosterone and prolactin serum levels were increased after acute (E1) and long-term (E2) haloperidol treatments in male and female rats, being this increment higher in female. Macrophage of male and female rats presented the same pattern of alterations after acute and long-term haloperidol treatments. Haloperidol-induced macrophage activation was discussed in the light of a possible indirect effect through prolactin increments in rats, or, alternatively, as a consequence of a direct action of macrophage dopamine receptor.     

五氟利多暗服药与氟哌啶醇治疗Tourette综合征对照研究

目的:对比研究五氟利多暗服药与氟哌啶醇治疗Tourette综合征的疗效和不良反应。方法:68例Tourette综合征患儿随机分为五氟利多组(34例)与氟哌啶醇组(34例),2组均治疗8wk。采用耶鲁抽动程度综合量表(YGTSS)评估治疗效果,采用不良反应症状量表(TESS)评估不良反应。结果:2组间治疗效果无显著性差异(P>0.05);五氟利多组的不良反应较氟哌啶醇组轻,2组间有显著性差异(P<0.01)。结论:五氟利多暗服药与氟哌啶醇治疗Tourette综合征均具有良好效果,但五氟利多暗服药服用方便,不良反应较少。     

Reboxetine: the first selective noradrenaline re-uptake inhibitor

Several treatment approaches are available for treatment of depression. However, reboxetine is the first selective noradrenaline re-uptake inhibitor. Whereas formerly only noradrenaline re-uptake inhibitors with a mixed mechanism of action were available. These included action not only at noradrenergic, but also at serotonergic and other neurotransmitter-sites. Thus, reboxetine represents the first of a new class of antidepressant agents with specificity for the noradrenergic system. Reboxetine has been shown to be an effective first-line treatment for patients with all grades of depression, to be effective in the prevention of relapse and recurrence and to offer significant benefits in terms of relieving the impaired social functioning associated with depressive disorders. Reboxetine was significantly superior to the serotonergic compound fluoxetine in improvement of social functioning in both the general depressed population and in those patients who achieved symptomatic remission, indicating a superior quality of remission. Altogether reboxetine was well tolerated during the acute and long-term treatment phase; side-effects such as increased sweating, constipation and dry mouth were the most prominent to be reported. The availability of reboxetine represents a significant addition to the currently available pharmacologic armamentarium for the treatment of depression.