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1.
对83例精神分裂症住院病人以氟哌啶醇癸酸酯治疗12~24周,给药剂量为2mg/kg,每4周肌注1次。以简明精神病评定量表(BPRS)、阴性症状评定量表(SNAS)评定疗效,以放射免疫法同时测定氟哌啶醇(HL)及还原氟哌啶醇(RH)浓度。结果显示,HL血浓度与临床反应间无显著相关,不同时点RH/HL比值与不同阶段BPRS、SANS减分率呈显著相关,这提示RH/HL比值在理解血药浓度与临床反应关系中有着重要作用。  相似文献   

2.
目的探讨银杏叶提取物结合氟哌啶醇对慢性精神分裂症的治疗作用。方法采用随机、双盲、空白对照法,用银杏叶提取物360mg/d结合氟哌啶醇(025mg/kg)对112例慢性精神分裂症患者进行治疗12周,在治疗前后评定BPRS、SAPS、SANS和TESS量表。结果银杏叶提取物结合氟哌啶醇治疗慢性精神分裂症的疗效比单用氟哌啶醇要好,前者BPRS、SAPS和SANS量表总分明显降低,而后者仅BPRS量表总分明显降低;同时前者治疗后SAPS量表评分显著低于后者;银杏叶提取物具有减轻氟哌啶醇锥体外系和行为毒性副反应的作用。结论银杏叶提取物可提高抗精神病药治疗慢性精神分裂症的疗效,并减轻抗精神病药副作用。  相似文献   

3.
目的 探讨免疫增强剂--左旋咪唑涂布剂合并氟哌啶醇治疗精神分裂症是否比单独应用氟哌啶醇效果更好。方法 将入组的精神分裂症患者分裂症患者机分为A、B、C三组,每组均为30例,A组氟哌啶醇、自来水涂布。口服氟哌啶醇,左施咪唑涂布剂涂布,C组口服淀粉、左旋咪唑涂布剂涂布;进行为期十二周的治疗。应用简明精神病评定量表()BPRS)、阳必 状评定量表(SAPS)、阴性症状谰定量表(SANS)、临床疗效总评量  相似文献   

4.
自知力教育配合治疗精神分裂症对照研究   总被引:3,自引:0,他引:3  
目的:探讨自知力教育在精神分裂症治疗中的作用。方法:对82例精神分裂症患者随机分组,应用自知力教育配合氟哌啶醇(40例)及单用氟哌啶醇(42例)进行对照治疗,疗程12周。采用简明精神病评定量表(BPRS)、阴性症状评定量表(SANS)、阳性症状评定量表(SAPS)、及自知力与治疗态度问卷表(ITAQ)进行测定。结果:自知力教育配合氟哌啶醇组疗效显著较好。结论:自知力教育配合治疗是治疗精神分裂症的有效方法,能较早、较好地出现治疗效果。  相似文献   

5.
银杏叶提取物对精神分裂症过氧经物歧化酶的作用   总被引:2,自引:0,他引:2  
目的 探讨银杏叶提取物(EGb)合并氟哌啶醇治疗对精神例症超氧化物歧化酶(SOD)的影响及其与临床疗效的关系,方法 用固定剂量银杏叶提取物合并氟哌啶醇随机,双盲治疗82例患者12周,在治疗前后分别评定简明精神症状下量表(BPRS),阳性症状评定量表(SPA格阴性症状下量表(SANS),并用双抗体放射免疫法测定SOD含量。结果 (1)治疗前精神分裂症阳性症状与SOD值正相关(r=0.36,P〈0.0  相似文献   

6.
目的 验证和比较哌泊噻嗪,氟哌啶醇癸酸酯,氟奋及静癸酸酯三种长效抗精神病制剂对精神分裂症的疗效及副反应。方法 采用多中心,开放随机对照研究,以简明精神病评定量表(BPRS),阳性症状评定量表(SAPS),阴性症状评定量表(SANS),临床疗效总评量表(CGI)和副反应量表(TESS),锥体外系副反应量表(RSESE)综合评定,结果 治疗后哌泊噻嗪组患者的CGI-SI与CGI-GI分值和SANS量表  相似文献   

7.
建桐翁正【摘要】目的验证和比较哌泊噻嗪、氟哌啶醇癸酸酯、氟奋乃静癸酸酯三种长效抗精神病制剂对精神分裂症的疗效及副反应。方法采用多中心、开放随机对照研究,以简明精神病评定量表(BPRS)、阳性症状评定量表(SAPS)、阴性症状评定量表(SANS)、临床疗效总评量表(CGI)和副反应量表(TESS)、锥体外系副反应量表(RSESE)综合评定。结果治疗后哌泊噻嗪组患者的CGISI与CGIGI分值和SANS量表总分均低于其它两组,差异均有显著性(P<0.05),而BPRS和SAPS量表总分治疗结束时三组间差异无显著性(P>0.05)。TESS总分和RSESE总分在整个治疗过程中均以氟奋乃静癸酸酯组最高,哌泊噻嗪组最低。结论三组中以哌泊噻嗪对精神分裂症的疗效较好,对阴性症状的改善优于氟哌啶醇癸酸酯组和氟奋乃静癸酸酯组,对阳性症状的疗效近似。哌泊噻嗪组副反应较少,安全度较好  相似文献   

8.
氟哌啶醇对精神分裂症超氧化物歧化酶的作用   总被引:3,自引:1,他引:2  
目的:探讨精神分裂症自由基代谢酶超氧化物歧化酶(SOD)在氟哌啶醇治疗前后的变化。方法:用固定剂量氟哌啶醇治疗46例慢性精神分裂症患者12周,在治疗前后应用放射免疫法测定血SOD含量,并评定BPRS、SAPS和SANS量表。结果:治疗前SOD值与SAPS总分正相关(P〈0.05)。治疗后,治疗前高SOD组明显降低,而低SOD组明显增高(P均〈0.05)。阴性型亚组中,治疗前SOD值与治疗前后SAN  相似文献   

9.
影响氟哌啶醇治疗精神分裂症疗效因素的分析   总被引:2,自引:0,他引:2  
为了进一步探讨影响氟哌啶醇(HL)治疗精神分裂症疗效的因素,对病程<5年的30例住院偏执型精神分裂症患者,以HL0.20mgkg-1d-1固定剂量治疗6周,以简明精神病评定量表、阳性症状评定量表、阴性症状评定量表(SANS)评定疗效,以药物不良反应量表评定治疗副反应,放射免疫法测定药物浓度。结果:药物不良反应与临床疗效呈显著负相关,疗效好的患者游离氟哌啶醇血浆浓度反而较低。SANS因子4(兴趣减少/社交活动减少)、因子5(注意障碍)的评分在治疗6周后比4周时有上升趋势。提示神经阻滞剂治疗造成的不良反应,会加重患者的某些阴性症状,最终导致总的临床疗效不满意。  相似文献   

10.
氟哌啶醇对慢性精神分裂症患者泌乳素的影响   总被引:2,自引:0,他引:2  
目的:探讨氟哌啶醇对泌乳素的影响及其与临床疗效的关系。方法:采用固定剂量氟哌啶醇治疗慢性精神分裂症45例,疗程12周,在治疗前后评定阳性与阴性症状量表(PANSS),并用放射免疫法测查血浆中泌乳素(PRL)浓度。  相似文献   

11.
Classical antipsychotics like haloperidol are suggested to increase oxidative stress and oxidative cell injury in the brain. Pro-oxidant effect of haloperidol may influence the course and treatment outcomes of schizophrenia. Dietary supplementation of either antioxidants or omega-3 fatty acids was found to improve symptoms of schizophrenia. Thus we decided to assess the impact of combining omega-3 fatty acids, vitamins E and C supplementation on treatment outcome and side effects in schizophrenia patients treated with haloperidol. Ongoing haloperidol treatment of 17 schizophrenia patients was supplemented with 1000 mg capsule of omega-3 fatty acids (180 mg EPA+120 mg DHA) bid, vitamin E 400 IU bid and vitamin C 1000 mg/day. Patients were assessed with Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Negative Symptoms (SANS), Simpson Angus Scale (SAS) and Barnes Akathisia Rating Scale (BARS) over a 4 month period. Gluthatione peroxidase, superoxide dismutase, malondialdehyde, vitamin E and C levels were also evaluated at baseline and at the end of study. BPRS, SANS, SAS and BARS scores obtained at follow-up visits were significantly lower compared to baseline. Superoxide dismutase level was significantly lower at the end of study. No significant differences were detected in other laboratory parameters. Our results support the beneficial effect of the supplementation on positive and negative symptoms of schizophrenia as well as the severity of side effects induced by haloperidol. The effect of supplementation on akathisia is especially noteworthy and it has not been investigated in previous studies.  相似文献   

12.
BACKGROUND: The choice of drug to treat a patient with schizophrenia is one of the most critical clinical decisions. Controversy exists on the differential efficacy of olanzapine. DATA SOURCES AND STUDY SELECTION: Raw data from all 4 registrational double-blind, random-assignment studies of olanzapine compared with placebo or haloperidol were obtained from Eli Lilly and Company for this meta-analysis. METHOD: Analysis of covariance of the intent-to-treat last-observation-carried-forward endpoint scores was used to assess efficacy on Brief Psychiatric Rating Scale (BPRS) and Positive and Negative Syndrome Scale (PANSS) total scores and the 5 factors derived by factor analysis (negative symptoms, positive symptoms, disorganized thoughts, impulsivity/hostility, and anxiety/depression). RESULTS: Olanzapine produced a statistically significantly greater reduction in schizophrenic symptoms than haloperidol (p < .05) on total scores on the BPRS and PANSS on each of the 5 factors as well as on almost all items. Olanzapine induced a response at a rate equal to that induced by haloperidol in the first few weeks, but by the end of the study produced a greater percentage of responders. Compared with haloperidol, olanzapine produced a somewhat greater response on symptoms responsive to haloperidol, but a markedly better response on symptoms unresponsive to haloperidol. This difference favoring olanzapine occurred to an equal degree in all subgroups examined. The incidence of parkinsonism or akathisia following olanzapine treatment was extremely low and not statistically distinguishable from placebo. CONCLUSION: Olanzapine produced a greater improvement than haloperidol particularly by benefiting a much larger number of items or factors. Extrapyramidal side effects and akathisia during olanzapine treatment were statistically indistinguishable from effects seen with placebo.  相似文献   

13.
Rosebush PI  Mazurek MF 《Neurology》1999,52(4):782-785
OBJECTIVE: To compare the side effect profile of risperidone with that of oral haloperidol in patients with no previous exposure to antipsychotic drugs (APDs). BACKGROUND: Early studies suggested that the APD risperidone may have a side effect profile comparable with that of placebo. These early studies involved patients with chronic schizophrenia and a long history of APD use. Very little information is available regarding the neurologic side effects of risperidone in patients without previous APD exposure. METHODS: The authors prospectively studied 350 consecutive neuroleptic-naive patients admitted to their acute-care psychiatry service; 34 of these were treated with risperidone (mean dose, 3.2 mg/d) and 212 were treated with low-dose haloperidol (mean dose 3.7 mg/d). All patients were assessed on admission and twice weekly thereafter using rating scales for dystonia, parkinsonism, akathisia, and dyskinesia. RESULTS: The incidence and severity of dystonic reactions, akathisia, parkinsonism, and dyskinesia were comparable in the risperidone- and haloperidol-treated groups. CONCLUSIONS: The neurologic side effect profile of low-dose risperidone is comparable with that of haloperidol in patients receiving APDs for the first time. Risperidone may not be a useful alternative to typical APDs for patients with PD and psychosis.  相似文献   

14.
目的:比较利培酮口服液合并氯硝西泮片与氟哌啶醇肌内注射治疗精神分裂症急性激越症状的疗效及不良反应。方法:60例精神分裂症急性激越症状患者,按1:1比例随机分入利培酮口服液(2~6mg/d)合并氯硝西泮片(2~8mg/d)组(利培酮组)或氟哌啶醇肌注(5~20mg/d)组(氟哌啶醇组)治疗,疗程7d。采用阳性和阴性症状量表(PANSS)、阳性和阴性症状量表兴奋因子(PANSS-EC)、病人合作程度评定表、修改版外显攻击行为量表(MOAS)、临床疗效总体评定量表(CGI)评定疗效,采用治疗中出现的症状量表(TESS)、静坐不能评定量表(BAS)、锥体外系副反应量表(SAS),不良事件和实验室检查评定安全性。结果:在治疗7d后,利培酮组和氟哌啶醇组PANSS-EC评分分别为(11.1,3.6)分和(12.9,5.2)分,较治疗前均明显进步(P<0.01),两组间PANSS-EC和PANSS总分差异无统计学意义(P>0.05);利培酮组在阳性因子分、MOAS、合作程度改善方面均优于氟哌啶醇组(P<0.05);肌强直、静坐不能的发生率显著低于氟哌啶醇肌注组(P<0.01)。结论:利培酮口服液合并氯硝西泮片治疗精神分裂症急性激越症状与氟哌啶醇肌内注射疗效相当,在某些方面优于氟哌啶醇肌内注射。  相似文献   

15.
BACKGROUND: Previous studies suggest that the serotonin-3 (5-HT3) receptor antagonist ondansetron possesses the therapeutic potential for schizophrenia. This study was designed to determine whether ondansetron as an adjunct to haloperidol could enhance the clinical efficacy and reduce the adverse side effects in chronic treatment-resistant schizophrenia. METHODS: Under double-blind, randomized conditions, 121 treatment-resistant inpatients with chronic DSM-IV-diagnosed schizophrenia received haloperidol (4-30 mg/day) combined with either placebo (N=63) or a fixed dose of 8 mg/day of ondansetron (N=58) for 12 weeks. Efficacy was defined as the change from baseline to endpoint in score on overall scale and subscales of the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity (CGI-S). Side effects were evaluated using the Treatment Emergent Symptom Scale and Extrapyramidal Symptom Rating Scale. RESULTS: Ondansetron combined with haloperidol produced a significantly greater improvement on PANSS overall scale and subscales for negative symptoms, general psychopathology, and cognition at endpoint compared to placebo with haloperidol, but no between-treatment group difference was observed on the subscale for positive symptoms and CGI-S. The ondansetron-treated group had a significantly higher proportion of patients with a 30% or greater baseline-to-endpoint reduction in PANSS total score than placebo. Patients in adjunctive ondansetron therapy also experienced significantly lower incidence and severity of parkinsonism and akathisia as well as fewer behavioral hyperactivity, cardiac, and gastrointestinal side effects. CONCLUSIONS: Ondansetron is an effective adjunctive agent in enhancing the effectiveness and reducing some adverse side effects of antipsychotic therapy for chronic, treatment-resistant schizophrenia, particularly for negative and cognitive symptoms.  相似文献   

16.
首发精神分裂症患者认知功能相关因素的5年随访   总被引:1,自引:0,他引:1  
目的探讨首发精神分裂症患者在急性期和维持治疗期认知功能与精神症状和社会功能的关系。方法对164例首发精神分裂症患者进行随访观察,于治疗前、治疗12周末、治疗1年末、2年末、3年末、4年末、5年末各做1次韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、手指敲击试验、动作功能测验、手功能协调测验、连线测验A和B、威斯康星卡片分类测验(WCST)及言语流利性测验等10项神经心理测查及简明精神症状评定量表(BPRS)、阴性症状评定量表(SANS)、功能总体评定量表(GAF)评定。结果治疗前各项认知功能测查结果与BPRS、SANS、GAF均无显著相关(P>0.05);治疗12周末、治疗1年末、2年末手指敲击测验、动作功能测验、总记忆商(MQ)等与BPRS总分显著相关(P<0.003);治疗12周末、治疗1年末、2年末、3年末、5年末铁槽铁钉测验、手指敲击测验、手功能协调性测验、智商(IQ)、MQ等与SANS、GAF总分显著相关(P<0.003)。结论治疗前首发精神分裂症患者认知功能与阳性症状、阴性症状、社会功能相互独立;维持治疗期随着疾病的演变,它们之间的相关性也在发生着变化。  相似文献   

17.
汪艳  北京  )  蔡丽伟  北京  )  张红星  杜波  金超  阎浩  北京  )  李玲芝  北京  )  刘琦  北京  )  闫俊  北京  )  马文斌  栗克清  吕路线  张鸿燕  北京  )  岳伟华  北京  )  张岱  北京  )  王力芳  北京  ) 《中国神经精神疾病杂志》2012,38(4):217-221
目的比较氟哌啶醇与奥氮平治疗精神分裂症的疗效及安全性。方法将符合精神分裂症诊断标准的住院患者按照1:2比例随机分为氟哌啶醇(n=120)和奥氮平治疗组(n=252),进行为期6周的治疗观察;于基线及治疗2、4、6周末评定阳性和阴性症状量表(positive and negative syndrom scale,PANSS),锥体外系副反应量表(rating scale for extrapyramdal side effects,RSESE)、静坐不能评定量表(barnes akathisia rating scale,BARS)和异常不自主运动量表(abnormal involuntary movement scale,AIMS);计算体质量指数(body mass index,BMI);基线及治疗4、6周末测定空腹血糖、血脂和肝功能等指标。结果氟哌啶醇组与奥氮平组基线PANSS总分差异无统计学意义;第6周末氟哌啶醇组PANSS总分低于奥氮平组(53.31±1.64 vs.58.05±1.02),减分率高于后者(60.63±2.86%vs.52.45±1.80%),均P<0.05;两组有效率(66.7%vs.62.7%)差异无统计学意义。第6周末氟哌啶醇组BMI较基线的变化值(0.08±0.20 kg/m2vs.0.91±0.12 kg/m2)、谷丙转氨酶异常病例数比例(16.98%vs.28.07%)均低于奥氮平组(P<0.05);第4周末氟哌啶醇组甘油三酯较基线的变化值低于奥氮平组(0.24±0.12 mmol/L vs.0.57±0.07 mmol/L),P<0.05。氟哌啶醇组锥体外系不良反应发生率(73.3%)明显高于奥氮平组(10.71%),P<0.05。结论在精神分裂症急性期,氟哌啶醇治疗有效率与奥氮平相当,对体重、血脂、转氨酶的影响较小,但锥体外系不良反应发生率较高。  相似文献   

18.
BACKGROUND: The frequency and severity of extrapyramidal syndrome (EPS) were evaluated in patients with DSM-III or DSM-IV schizophrenia in the acute phase (- 8 weeks) of randomized, double-blind, controlled trials from the integrated olanzapine clinical trial database. METHOD: This retrospective analysis included 23 clinical trials and 4611 patients from November 11, 1991, through July 31, 2001. Incidences of dystonic, parkinsonian, and akathisia events were compared using treatment-emergent adverse-event data. Categorical analyses of Simpson-Angus Scale and Barnes Akathisia Scale (BAS) scores, use of anticholinergic medications, and baseline-to-endpoint changes in Simpson-Angus Scale and BAS scores were compared. RESULTS: A significantly smaller percentage of olanzapine-treated patients experienced dystonic events than did haloperidol- (p <.001) or risperidone-treated patients (p =.047). A significantly greater percentage of haloperidol-treated patients experienced parkinsonian (p <.001) and akathisia (p <.001) events than did olanzapine-treated patients. Categorical analysis of Simpson-Angus Scale scores showed significantly more haloperidol- (p <.001) or risperidone-treated patients (p =.004) developed parkinsonism than did olanzapine-treated patients. Olanzapine-treated patients experienced significantly greater reductions in Simpson-Angus Scale scores than did haloperidol- (p <.001), risperidone- (p <.001), or clozapine-treated (p =.032) patients. Categorical analysis of BAS scores showed significantly more haloperidol-treated patients experienced treatment-emergent akathisia versus olanzapine-treated patients (p <.001). Significantly greater reductions in BAS scores were experienced during olanzapine treatment versus placebo (p =.007), haloperidol (p <.001), and risperidone (p =.004) treatments. A significantly smaller percentage of olanzapine-treated patients received anticholinergic medications compared with that of haloperidol- (p <.001) or risperidone-treated patients (p =.018). Compared with that in olanzapine-treated patients, the duration of anticholinergic cotreatment was significantly longer among haloperidol- (p <.001) or risperidone-treated patients (p =.040) and significantly shorter among clozapine-treated patients (p =.021). CONCLUSION: This analysis of available data from olanzapine clinical trials lends additional support to olanzapine's favorable EPS profile.  相似文献   

19.
OBJECTIVE: To determine the antipsychotic efficacy and extrapyramidal safety of intramuscular (i.m.) olanzapine and i.m. haloperidol during the first 24 hours of treatment of acute schizophrenia. METHOD: Patients (n = 311) with acute schizophrenia were randomly allocated (2:2:1) to receive i.m. olanzapine (10.0 mg, n = 131), i.m. haloperidol (7.5 mg, n = 126), or i.m. placebo (n = 54). RESULTS: After the first injection, i.m. olanzapine was comparable to i.m. haloperidol and superior to i.m. placebo for reducing mean change scores from baseline on the Brief Psychiatric Rating Scale (BRPS) Positive at 2 hours (-2.9 olanzapine, -2.7 haloperidol, and -1.5 placebo) and 24 hours (-2.8 olanzapine, -3.2 haloperidol, and -1.3 placebo); the BPRS Total at 2 hours (-14.2 olanzapine,-13.1 haloperidol, and -7.1 placebo) and 24 hours (-12.8 olanzapine, -12.9 haloperidol, and -6.2 placebo); and the Clinical Global Impressions (CGI) scale at 24 hours (-0.5 olanzapine, -0.5 haloperidol, and -0.1 placebo). Patients treated with i.m. olanzapine had significantly fewer incidences of treatment-emergent parkinsonism (4.3% olanzapine vs 13.3% haloperidol, P = 0.036), but not akathisia (1.1% olanzapine vs 6.5% haloperidol, P = 0.065), than did patients treated with i.m. haloperidol; they also required significantly less anticholinergic treatment (4.6% olanzapine vs 20.6% haloperidol, P < 0.001). Mean extrapyramidal symptoms (EPS) safety scores improved significantly from baseline during i.m. olanzapine treatment, compared with a general worsening during i.m. haloperidol treatment (Simpson-Angus Scale total score mean change: -0.61 olanzapine vs 0.70 haloperidol; P < 0.001; Barnes Akathisia Scale global score mean change: -0.27 olanzapine vs 0.01 haloperidol; P < 0.05). CONCLUSION: I.m. olanzapine was comparable to i.m. haloperidol for reducing the symptoms of acute schizophrenia during the first 24 hours of treatment, the efficacy of both being evident within 2 hours after the first injection. In general, more EPS were observed during treatment with i.m. haloperidol than with i.m. olanzapine.  相似文献   

20.
Previous clinical trials have clearly shown the superiority of olanzapine to haloperidol in the improvement of extrapyramidal symptoms (EPS) in schizophrenic patients. The primary purpose of this study was to compare EPS profiles in Japanese schizophrenic patients treated with an atypical antipsychotic, olanzapine, or a typical antipsychotic, haloperidol, as measured by the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS). The DIEPSS, which consists of eight individual parameters and one global assessment (overall severity), was used to evaluate 182 patients enrolled in this 8-week study. The primary safety analysis was maximum change (that could be either a decrease or increase) from baseline in DIEPSS total score. Secondary analyses included change from baseline to maximum in DIEPSS total score, change from baseline to endpoint (LOCF) in DIEPSS total score, and the rank sum of the maximum change (that could be either a decrease or increase) from baseline in the DIEPSS individual items. Incidence of treatment-emergent EPS adverse events using the DIEPSS scale was also analyzed. The olanzapine group showed statistically significant superiority to the haloperidol group on the primary analysis (p<0.001). Secondary analyses also demonstrated olanzapine's superiority in DIEPSS total, parkinsonism, akathisia and overall severity scores (all p< or =0.014). Categorical analysis of treatment-emergent akathisia and parkinsonism syndromes at endpoint showed improvement in the olanzapine group but worsening in the haloperidol group. The results from this study suggest that olanzapine, as in Caucasian populations, is a safe treatment in Japanese patients chronically ill with schizophrenia.  相似文献   

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