齐拉西酮治疗以阴性症状为主的精神分裂症对照研究

目的评价齐拉西酮对以阴性症状为主的精神分裂症的疗效和副作用。方法对60例以阴性症状为主的精神分裂症的住院患者按治疗药物不同分为2组，每组30例，分别服用齐拉西酮和氯氮平，治疗8周。采用阴性和阳性量表（PANSS）、阴性症状量表（SANS）和不良反应量表（TESS）等评定疗效和副作用。结果齐拉西酮组和氯氮平组的疗效相当，但副作用明显轻于氯氮平。结论齐拉西酮是一种安全有效的抗精神病药，对精神分裂症的阴性症状有显著的疗效，值得临床推广使用。     

利培酮与氯氮平治疗精神分裂症阴性症状对照研究

目的比较利培酮与氯氮平治疗精神分裂症阴性症状的疗效及副反应。方法对80例以阴性症状为主的精神分裂症住院患者,随机分为两组,分别用利培酮和氯氮平治疗8周,采用阴性症状量表(SANS)和简明精神病评定量表(BPRS)评定疗效,副反应量表(TESS)评定药物副反应。结果利培酮对以阴性症状为主的精神分裂症的疗效稍优于氯氮平,且利培酮的副反应发生率低。结论利培酮是治疗精神分裂症阴性症状较理想的药物,值得进一步推广使用。     

3种抗精神病药对精神分裂症患者糖脂代谢和生活质量的影响

目的:比较3种常用的抗精神病药对精神分裂症患者糖脂代谢和生活质量的影响。方法:选取2017年1月—2019年12月上海市宝山区精神卫生中心收治的精神分裂症患者324例,按照所服用药物分为奥氮平组、利培酮组和齐拉西酮组,每组各108例,比较治疗过程中糖脂代谢情况及生活质量。结果:治疗8周后奥氮平组FBS水平较治疗前升高(P0.05);奥氮平组和利培酮组治疗8周后患者体重均较治疗前显著提高(P0.05);奥氮平组治疗4周后和治疗8周后患者TG和TC水平较治疗前显著提高(P0.05);齐拉西酮组生活质量指标略高于其他两组(P0.05)。结论:奥氮平、利培酮和齐拉西酮3种非典型抗精神病药均可用于精神分裂症的治疗,可显著提高患者生活质量,其中齐拉西酮对糖脂代谢的影响不明显。     

利培酮与氯氮平治疗精神分裂症对照研究

目的对比研究利培酮与氯氮平用于治疗精神分裂症的临床疗效与影响。方法随机选取就诊于我院精神科确诊的精神分裂症患者66例。分组为利培酮组与氯氮平组,各33例。其中利培酮组单独使用利培酮进行治疗;氯氮平组患者使用氯氮平对精神分裂症进行治疗。比较两组患者经过不同药物治疗后简明精神病量表、康复疗效评定量表及治疗总有效率等指标。结果两组患者治疗后总有效率均为97％以上,治疗效率无显著差异（P〉0．05）。利培酮组不良反应发生人数显著少于氯氮平组患者（P〈0．05）。结论使用利培酮与氯氮平对精神分裂症患者进行治疗疗效显著。利培酮服药后不良反应较轻,患者耐受性较好,治疗安全性高。氯氮平起效速度快,但服药后不良反应相对较多。两种药物均能够有效缓解精神分裂症患者临床症状,提高疾病治疗效率并改善患者生活质量,临床用药时应根据患者具体情况酌情用药。     

精神分裂症住院病人用药性别差异情况调查分析

目的:为了解男女精神分裂症患者住院用药情况.方法:对我院精神科封闭病房住院接受抗精神病药物治疗的233例精神分裂症患者不同性别用药进行回顾性分析,其中男性117例,女姓116例.结果:男、女患者精神药物使用频率居首的为氯氮平,居前五位的均为氯氮平,舒必利,利培酮,氯丙嗪,奋乃静;单一抗精神病药物为主;非典型抗精神病药物的使用率超过典型抗精神病药物;服用前五位抗精神病药物的日平均最大剂量女性高:精神药物联合治疗男性高于女性.结论:住院精神分裂症病人在抗精神病药联合治疗上及部分药物的日平均最大剂量有性别差异.     

非典型抗精神病药物对心脏的影响

目的探讨非典型性抗精神病药物对心电图的影响。方法选择2009年12月—2014年12月在本院住院治疗的精神分裂症患者,随机抽取服用非典型新抗精神病药物的精神分裂症患者153例为治疗组,服用常规剂量的氯氮平、利培酮、喹硫平、齐拉西酮、阿立哌唑等非典型性抗精神病药物;停用抗精神病药物1年以上的精神分裂症患者30例为对照组,分别进行心电图检查,并对各种非典型性精神病药物与心电图异常的关系、服药时间与心电图异常的关系以及两组间心电图具体的改变进行分析对比。结果治疗组与对照组心电图异常发生率分别为59.5%、13.3%,两组间差异有统计学意义(P0.05);治疗组中氯氮平心电图异常发生率为73.5%,利培酮为48.6%、齐拉西酮为45.5%、阿立哌唑为46.2%。短于1年的异常率为50%,1~2年为58.3%,2~3年为62.3%,3~4年为43.3%,超过4年的为71.9%。治疗组中窦性心动过速39例(25.5%),窦性心动过缓8例(5.2%),结性期前收缩1例,室性期前收缩3例,室上性心动过速1例,室性心动过速1例;ST段下移8例(5.2%),T波改变10例(6.5%),QT间期延长8例(5.2%);传导障碍11例(7.2%);心室肥厚12例(7.8%)。对照组窦性心动过速及窦性心动过缓各1例,ST段下移及QT间期延长各1例,传导障碍1例。结论非典型新抗精神病药物对心脏有影响,应用时应及时监测心电图。     

精神分裂症患者应用齐拉西酮和利培酮治疗的疗效评价

目的:对精神分裂症患者应用齐拉西酮和利培酮治疗的疗效评价。方法:抽选我院2017年7月～2018年7月所接诊的88例精神分裂症患者作为研究对象,按随机数字表法将其分成联合组与参照组。对参照组患者予以利培酮药物治疗,而对联合组患者予以齐拉西酮治疗。对两组患者治疗后的临床效果进行观察与分析。结果:就治疗总有效率而言,联合组患者(95.45%)明显比参照组患者(84.01%),差异明显(χ~2=4.351,P 0.05)。结论:对精神分裂症患者采取齐拉西酮治疗,疗效优于利培酮,效果甚佳,且不良反应少。     

齐拉西酮与利培酮对首发精神分裂的治疗效果对比研究

目的：考察齐拉西酮对首发精神分裂症患者的治疗效果与安全性。方法：以利培酮作为对照药物,共选择73例首发精神分裂症患者,并将其随机分为齐拉西酮组（40例）与利培酮组（33例）,齐拉西酮组采用齐拉西酮进行治疗,利培酮组采用利培酮进行治疗。结果：治疗8周后两组患者PANSS评分均较治疗前显著降低（P〈0.05）,但组间比较并无统计学意义（P〉0.05）;齐拉西酮组与利培酮组总有效率分别为92.5%和90.9%,组间比较无统计学意义（χ2=0.738,P=0.082）,对应不良反应发生率分别为32.5%与33.3%,组间比较无统计学意义（χ2=0.802,P=0.087）。结论：齐拉西酮为当前一种颇具安全性与有效性的新型抗精神病药物,其对首发精神分裂症的治疗效果与利培酮相当,值得临床进一步推广应用。     

齐拉西酮与利培酮治疗精神分裂症疗效的Meta分析

[目的]比较国内齐拉西酮与利培酮治疗精神分裂症疗效.[方法]采用Review Manager 4.2分析软件,对国内11篇有关齐拉西酮与利培酮治疗精神分裂症疗效的研究结果进行固定效应模型的Meta分析.[结果]齐拉西酮治疗精神分裂症的总显效率和总有效率均与利培酮组无差别,合并RR分别为0.96和0.95,95%可信区间分别为0.87～1.05和0.90～1.000.[结论]齐拉西酮与利培酮治疗精神分裂症患者疗效相当,其不良反应小,是一种安全有效的新型抗精神分裂症药物.     

非典型抗精神病药物对首发精神分裂症的疗效分析

目的为了提高首发精神分裂症患者的总体临床治疗效果,探讨分析应用非典型抗精神病药物对首发精神分裂症患者所起到的临床疗效。方法回顾分析该院近年来住院就诊的120例首发精神分裂症患者,将其随机分为四个研究组,即研究1组(阿立哌唑)、研究2组(齐拉西酮)、研究3组(奎硫平)以及研究4组(利培酮),四个研究组患者的一般临床资料比较,差异无统计学意义(P>0.05),具体对比分析四个研究组患者治疗前后阳性及阴性症状量表(PANSS)的变化情况。结果从四个研究组的总体疗效对比情况来看,其差异无统计学意义(P>0.05),但是相对于其他三个研究组来说,研究4组患者的血清催乳素水平以及月经紊乱情况表现较高。结论对于首发精神分裂症患者采用非典型抗精神病药物治疗的效果明确,无明显差异,值得推广应用。     

齐拉西酮与奥氮平治疗女性精神分裂症的对照研究

目的：比较齐拉西酮与奥氮平治疗女性精神分裂症的疗效及安全性。方法：采用随机、单盲对照的方法,将80例女性精神分裂症患者随机分为两组,每组各40例,分别使用齐拉西酮和奥氮平对照治疗8周,采用阳性症状与阴性症状（PANSS）评定疗效,采用副反应量表（TESS）评定副反应。结果：两组疗效相当,但齐拉西酮组较奥氮平组引起的不良反应更少,对患者的体重无显著性影响,不易引起嗜睡。结论：齐拉西酮是一种安全有效的抗精神病药,较适合女性精神分裂症患者的治疗。     

A decision model to compare health care costs of olanzapine and risperidone treatment for schizophrenia in Germany

Second-generation atypical antipsychotics such as clozapine, olanzapine, risperidone, quetiapine, ziprasidone, amisulpride and ariprazole offer the potential to reduce the significant health care resource demands in the treatment of schizophrenia through improved levels of initial clinical response and reduced levels of long-term acute relapse. However, the optimal sequencing of these drugs remains unclear. To consider this issue from a health economic viewpoint a decision model approach was used comparing healthcare costs and clinical outcomes when treating patients with alternative sequences of atypical antipsychotic treatment. Treated patients were assumed to be in a current acute episode with at least a 10-year history of disease and to be naive to previous atypical treatments. Treatment strategies were based on either first-line olanzapine or risperidone with switching to the alternative drug as second-line treatment following an inadequate clinical response to first-line drug therapy. Clinical response data were derived from a pivotal published comparative study of both olanzapine and risperidone. Published data on the long-term use of antipsychotic drugs where used wherever possible to populate the model for relapse rates during the maintenance phase. Health care resource data were defined for Germany based on expert clinical opinion. A treatment strategy of first-line olanzapine was shown to be cost saving over a 1-year period, with additional clinical benefits in the form of avoided relapses. The model suggests that over the first year of treatment a strategy of first-line olanzapine is associated with lower risk of additional relapse (0.33 fewer acute relapses per 100 patients per year) and with cost savings (euro 35,306 per 100 patients per year). There is a need for longer term direct in-trial comparisons of atypical antipsychotics to confirm these indicative results.     

Cost-effectiveness model comparing olanzapine and other oral atypical antipsychotics in the treatment of schizophrenia in the United States

Background

Schizophrenia is often a persistent and costly illness that requires continued treatment with antipsychotics. Differences among antipsychotics on efficacy, safety, tolerability, adherence, and cost have cost-effectiveness implications for treating schizophrenia. This study compares the cost-effectiveness of oral olanzapine, oral risperidone (at generic cost, primary comparator), quetiapine, ziprasidone, and aripiprazole in the treatment of patients with schizophrenia from the perspective of third-party payers in the U.S. health care system.

Methods

A 1-year microsimulation economic decision model, with quarterly cycles, was developed to simulate the dynamic nature of usual care of schizophrenia patients who switch, continue, discontinue, and restart their medications. The model captures clinical and cost parameters including adherence levels, relapse with and without hospitalization, quality-adjusted life years (QALYs), treatment discontinuation by reason, treatment-emergent adverse events, suicide, health care resource utilization, and direct medical care costs. Published medical literature and a clinical expert panel were used to develop baseline model assumptions. Key model outcomes included mean annual total direct cost per treatment, cost per stable patient, and incremental cost-effectiveness values per QALY gained.

Results

The results of the microsimulation model indicated that olanzapine had the lowest mean annual direct health care cost ($8,544) followed by generic risperidone ($9,080). In addition, olanzapine resulted in more QALYs than risperidone (0.733 vs. 0.719). The base case and multiple sensitivity analyses found olanzapine to be the dominant choice in terms of incremental cost-effectiveness per QALY gained.

Conclusion

The utilization of olanzapine is predicted in this model to result in better clinical outcomes and lower total direct health care costs compared to generic risperidone, quetiapine, ziprasidone, and aripiprazole. Olanzapine may, therefore, be a cost-effective therapeutic option for patients with schizophrenia.     

齐拉西酮与奥氮平治疗精神分裂症的临床疗效观察

目的 对比观察齐拉西酮和奥氮平治疗精神分裂症的临床疗效.方法 78例精神分裂症患者被随机分为两组,分别给予齐拉西酮和奥氮平口服治疗,比较两组患者的治疗疗效及不良反应（TESS量表）,并于治疗前,治疗后1、2、4、8周记录PANSS评分比较.结果 两组治疗结束时PANSS评分较治疗前明显降低（P＜0.05）;治疗开始后,齐拉西酮组各时间点PANSS减分率于奥氮平组无明显差异（P＞0.05）;两组不良反应发生率无明显差异（P＞0.05）,但奥氮平组以体重增加为主,齐拉西酮组以心动过速,失眠,恶心为主,两组间差异具有统计学意义（P＜0.05）;奥氮平治疗的有效率为79.5％,齐拉西酮治疗的有效率为84.6％,两组间无明显差异（P＞o.05）.结论 奥氮平和齐拉西酮均能有效治疗精神分裂症,两种药物的主要不良反应不同,可根据患者情况具体选择相应药物.     

齐拉西酮与利培酮治疗女性精神分裂症患者对照观察

目的 探讨齐拉西酮与利培酮治疗女性精神分裂症患者的疗效及安全性.方法 采用随机双盲对照研究,将100例女性精神分裂症住院患者随机分为齐拉西酮组、利培酮组,各50例.疗程12周.以阳性与阴性症状量表（PANSS）评定疗效,以治疗中出现的症状量表（TESS）评定不良反应,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,同时检测体质量、血糖及催乳素.结果 齐拉西酮组与利培酮组的总体疗效相当;利培酮较齐拉西酮引起的锥体外系反应及抗胆碱能作用发生率高;齐拉西酮对血清催乳素、血糖、体质量影响较利培酮小;齐拉西酮组WHOQOL-100各领域评分均明显改善.结论 齐拉西酮与利培酮疗效相当,不良反应小,能明显改善患者生活质量.     

首发精神分裂症药物的选择及疗效比较

目的比较临床常用首发精神分裂症药物的药效、副反应。方法选取我院及成都市第四人民医院2011年8月至2012年10月门诊及住院的首次发病精神病患者91例,随机分为奥氮平组（30例）、利培酮组（31例）和帕利哌酮组（30例）,治疗8W后对疗效、不良反应情况进行统计分析。结果3组药物均能有效治疗首发精神分裂症,治疗前后相关指标比较差异均有统计学意义（P〈0．01）,3组之间疗效差异无统计学意义（P〉0．05）;奥氮平组锥体外系反应较少;帕利哌酮组对肝脏的损伤较少;利培酮组不易导致体重增加。结论临床应针对不同患者情况选择首发精神分裂症药物。     

A 1-Year Cost-Effectiveness Model for the Treatment of Chronic Schizophrenia with Acute Exacerbations in Belgium

OBJECTIVE: A 1-year semi-Markov model was constructed to simulate the cost-effectiveness of atypical and typical antipsychotic treatments for schizophrenia. METHODS: The core model comprised nine 6-week cycles and includes events such as survival, response, adverse events, and compliance. The nature, duration, intensity, and timing of adverse events were incorporated. Compliance was modeled as a function of health state, time, and adverse events. Three first-line treatments were considered (risperidone, olanzapine, and haloperidol oral) and the transition probabilities of switching between five different therapies (haloperidol oral, haloperidol depot, risperidone, olanzapine and clozapine) were included. Effectiveness was modeled based on a modified method of TWiST (time without symptoms and toxicity). The direct costs of utilization of medical resources are taken into account, including five different patient care settings, consultations, neuroleptic medication, laboratory tests, and treatment of side-effects. RESULTS: This paper reports the methodology used to construct the model and the results obtained when it was applied to the treatment of patients with schizophrenia in the Belgian health care system. CONCLUSIONS: Over the study period, risperidone and olanzapine were more cost-effective than haloperidol and of the two major atypical drugs, risperidone was the more cost-effective.     

Current pharmacotherapy of schizophrenia

Second generation antipsychotics have become the standard of modern pharmacotherapy of schizophrenia. Amisulprid, clozapine, olanzapine, quetiapine, risperidone, sertindol, ziprasidone are the second generation antipsychotics registered in Hungary. They are more efficacious and their side effects are less stigmatizing than those of the first generation of antipsychotic drugs. Their use is limited by the availability of different formulations, by the lack of experience of some physicians, however the main limitation is the economic barrier.     

齐拉西酮对首发精神分裂症患者疗效及生活质量的影响

目的探讨齐拉西酮对精神分裂症患者疗效及生活质量的影响。方法60例精神分裂症患者随机分为齐拉西酮组和利培酮组各30例,并于基线、12周末,随访至24周末时对2组患者采用阳性和阴性症状量表（PANSS）、副反应量表（TESS）进行疗效、不良反应评定;采用健康状况调查问卷（SF-36）进行生活质量评估。结果2组治疗前后PANSS评分差异均有统计学意义（P〈0．01）,治疗后组间比较,差异无统计学意义（P〉0．05）。TESS评分,齐拉西酮组显著低于利培酮组;治疗后齐拉西酮组SF-36评分均明显高于利培酮组。结论齐拉西酮治疗精神分裂症与利培酮的疗效相当,但不良反应少,显著改善患者的生活质量。     

利培酮治疗难治性精神分裂症随机对照研究

目的比较利培酮和氯氮平治疗难治性精神分裂症的疗效及安全性。方法共入组60例符合Kane难治性精神分裂症定义的患者,随机服用氯氮平和利培酮治疗,两组各30例,观察16周,分别于治疗前、治疗1周末、2周末、4周末、8周末、12周末、治疗16周末评定阳性症状和阴性症状量表(PANSS)、治疗中副反应量表(TESS)、功能总体评定量表(GAF)各一次。治疗前后还需评定韦氏记忆量表(MQ)和威斯康星卡片分类测验(WCST)各一次并测量体重。结果无论是服用氯氮平治疗的患者,还是服用利培酮治疗的患者,基线时各项指标没有差异,治疗第4周末GAF量表得分明显增加,治疗第8周末PANSS总分、阴性症状因子分明显降低,治疗第12周末PANSS总分及各因子分均明显降低,差异均有非常显著性。治疗第16周末,利培酮组TESS量表得分明显低于氯氮平组,而GAF量表得分明显高于氯氮平组,差异均有非常显著性。结论氯氮平和利培酮治疗难治性精神分裂症患者疗效相当,且利培酮的副反应更轻,更利于患者社会功能的改善。