阿立哌唑与利培酮治疗精神分裂症对照研究

阿立哌唑（aripiprazole），商品名博思清，是一种喹诺酮的衍生物，被称为“多巴胺和5一羟色胺系统稳定剂”，2004年底在国内开始使用。国内外的一些研究资料表明，该药对精神分裂症的阳性、阴性症状均有确切疗效，且安全性高。本文以利培酮为对照，进一步验证其对国内患者的疗效及安全性。     

阿立哌唑及利培酮治疗男性精神分裂症的疗效及对性功能的影响

[目的]探讨阿立哌唑治疗精神分裂症的疗效及对男性性功能的影响.[方法]将84例已婚男性精神分裂症患者随机分为两组各42例,分别给予阿立哌唑与利培酮治疗,疗程12周.于治疗前及治疗4周、6周、12周末采用阳性与阴性症状量表(PANSS)、副反应量表(TESS)及性功能评定评价临床疗效及不良反应.[结果]治疗12周末阿立哌唑组显效率81%,有效率92.9%;利培酮组显效率78.6%,有效率90.5%,两组显效率与有效率比较差异均无显著性(P均>0.05).治疗12周后阿立哌唑组性唤起因子分、性功能总分显著高于利培酮组(P<0.01).在入组后4周,8周及12周,利培酮组的性欲、性唤起、性高潮及性功能总分均显著低于基线值(P<0.01).[结论]阿立哌唑治疗精神分裂症疗效与利培酮相当,安全性高,对男性性功能影响小,依从性好     

阿立哌唑与舒必利联合治疗精神分裂症对比分析

目的 探讨阿立哌唑联合舒必利治疗精神分裂症的疗效和安全性.方法 将80例精神分裂症患者随机分为阿立哌唑联合舒必利组和舒必利组各40例,共治疗8周,在治疗前及治疗后1、2、4、6、8周末分别采用PANSS、TESS进行评定.结果 两组治疗前后PANSS评分均明显降低,阿立哌唑组在第2、4、6、8周PANSS评分少于舒必利组.结论 阿立哌唑联合舒必利组能更快地改善精神症状,不良反应未见增高.     

齐拉西酮与阿立哌唑治疗精神分裂症的对比分析

齐拉西酮是一种新型非典型抗精神病药，选择其与阿立哌唑对照，应用于精神分裂症患者，报道如下。     

国产齐拉西酮与利培酮治疗精神分裂症对比分析

目的 探讨齐拉西酮治疗首发精神分裂症的临床效果及安全性.方法 将90例精神分裂症患者随机分为两组,分别给予齐拉西酮与利培酮治疗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 齐拉西酮组治疗总有效率为80.43%,利培酮组为81.82%,两组比较差异无统计学意义(P>0.05).但齐拉西酮组的不良反应稍低于利培酮组(P<0.05).结论 齐拉西酮与利培酮治疗首发精神分裂症的疗效相当,且齐拉西酮不良反应少.     

利培酮治疗精神分裂症60例分析

目的：探讨利培酮治疗精神分裂症患者的临床疗效和安全性。方法：对60例精神分裂症患者给予利培酮治疗,疗程12周。分别于治疗前及治疗第2周、4周、6周、8周、12周末采用阴性和阳性症状量表、简明精神病评定量表、不良反应量表评定临床疗效和不良反应。结果：治疗12周末,研究组总有效率为96.7%,利培酮治疗各时点阴性和阳性症状量表及简明精神病评定量表评分均呈持续性下降（P〈0.01）,不良反应轻微。结论：利培酮治疗精神分裂症疗效显著,安全性高,不良反应轻微。     

阿立哌唑与哌罗匹隆治疗精神分裂症对比分析

目的探讨阿立哌唑治疗精神分裂症的临床效果及安全性。方法将278例精神分裂症患者随机分为两组,分别给予阿立哌唑与哌罗匹隆治疗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。结果阿立哌唑组治疗总有效率为82.6%,哌罗匹隆组为82.1%,两组比较差异无统计学意义(P>0.05)。但阿立哌唑组的不良反应低于哌罗匹隆组(P<0.05)。结论阿立哌唑与哌罗匹隆治疗首发精神分裂症的疗效相当,且阿立哌唑不良反应少。     

利培酮口服液治疗合并躯体疾病的精神分裂症临床观察

抗精神病药均有一定的副作用,尤其对于合并躯体疾病的患者,更应选择副作用小的药物,以保证安全.利培酮口服液治疗合并躯体疾病的精神分裂症,国内报道尚少,我们开展有关临床观察,现报告如下.     

阿立哌唑与氯氮平治疗难治性精神分裂症的对照观察

目的：观察阿立哌唑治疗难治性精神分裂症的的临床疗效及安全性。方法：将100例临床诊断为难治性精神分裂症的患者随机平均分成两组,分别用阿立哌唑与氯氮平治疗6周,用简明精神病病评定量表（BPRS）及副反应量表（TESS）评定疗效及副反应。结果：阿立哌唑组疗效与氯氮平组疗效相当且无严重的不良反应。结论：阿立哌唑是治疗难治性精神分裂症安全而有效的药物,适合临床应用。     

利培酮联合氯氮平治疗难治性精神分裂症的临床疗效

目的：探讨利培酮联合氯氮平治疗难治性精神分裂症的临床疗效。方法：利培酮联合氯氮平治疗难治性精神分裂症,并与单一使用利培酮、氯氮平组进行疗效对比。结果：经统计分析发现联合组显著进步的患者及总有效率均明显高于利培酮组和氯氮平组,差异具有统计学意义（P〈0.05）。结论：利培酮联合氯氮平治疗难治性精神分裂症疗效显著。     

利培酮合并氯氮平治疗难治性精神分裂症

目的了解利培酮与氯氮平合并治疗难治性精神分裂症的疗效与安全性。方法 38例符合中国精神疾病分类方案与诊断标准第3版精神分裂症诊断标准,且临床判断属于难治性患者,给予利培酮合并氯氮平治疗,疗程为8周,分别在治疗前后进行阳性与阴性症状量表(PANSS)和副反应量表(TESS)评定。结果两药合并治疗8周后总有效率为73.7%,PANSS阳性、阴性及一般精神病理分值治疗前后比较差异均有统计学意义(P<0.01),TESS总分治疗前后比较差异无统计学意义(P>0.05)。结论利培酮合并氯氮平治疗难治性精神分裂症疗效肯定,安全性高,值得临床应用。     

阿立哌唑替换利培酮治疗对精神分裂症患者血清催乳素水平的影响

目的:研究阿立哌唑替换利培酮治疗对精神分裂症患者血清催乳素水平的影响。方法:伴有高催乳素血症的精神分裂症患者128例,随机分为利培酮组(维持利培酮治疗)和阿立哌唑(阿立哌唑替代利培酮治疗)组,治疗8周。于第0、1、2、4、6及8周测血清催乳素水平及身体质量指数(BMI);在入组时和治疗8周时采用阳性与阴性症状量表(PANSS)和临床总体印象量表(CGIS)测定疗效。结果:可用于评估的数据101例,利培酮组53例,阿立哌唑组48例。阿立哌唑组替换治疗后第1周血清催乳素水平即明显下降,第8周时,显著低于利培酮组(P<0.001);2组BMI、PANSS及CGIS评分及变化差异无统计学意义。结论:阿立哌唑替换利培酮可降低伴有高催乳素血症的精神分裂症患者的血清催乳素水平。     

阿立哌唑与利培酮治疗精神分裂症的疗效比较

目的对比阿立哌唑与利培酮治疗精神分裂症的临床疗效。方法研究对象选取为2015年1~12月我院收治的100例精神分裂症患者,采用数字表法随机分为观察组和对照组各50例,观察组患者给予阿立哌唑治疗,对照组患者则采用利培酮治疗,对比两组患者的临床疗效及不良反应情况。结果观察组患者总有效率为88.0%,显著高于对照组的70.0%,差异具有统计学意义(P0.05);两组患者的主要不良反应均为嗜睡、头晕、恶心呕吐及锥体外系损害,观察组患者的总体不良反应发生率为30.0%,对照组总体不良反应发生率为46.0%,观察组显著低于对照组,差异具有统计学意义(P0.05)。结论阿立哌唑治疗精神分裂症的疗效确切,安全性好,与利培酮相比更具优势,值得在临床上推广和应用。     

Aripiprazole in schizophrenia: consensus guidelines

Schizophrenia is a chronic disabling disease which in the majority of cases requires long-term treatment with antipsychotic medication. Before the development of atypical antipsychotics, treatment choice was restricted to conventional (or typical) antipsychotics, which are known to cause a range of side effects including extrapyramidal symptoms. Although atypical agents provide a favourable alternative (advocated by the National Institute of Clinical Excellence in the UK), they are associated with side effects. These differ between agents, but can include weight gain, sedation and hyperprolactinaemia. Aripiprazole is a newly available atypical antipsychotic for the treatment of schizophrenia. With the apparent imitations of currently available medications, aripiprazole provides clinicians with another treatment option. The purpose of these guidelines is to outline the consensus reached by the Schizophrenia Innovation Working Group on best practice in prescribing and appropriate use of aripiprazole in the UK.     

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：72例符合CCMD-3精神分裂症患者分为2组各36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：2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。     

阿立哌唑和利培酮对首发精神分裂症患者记忆功能的影响

目的探讨阿立哌唑和利培酮对首发精神分裂症患者记忆功能的影响。方法 112例首发精神分裂症患者随机分成阿立哌唑组和利培酮组,每组56例。在治疗前和治疗12周末采用韦氏记忆量表-第三版的空间广度测验（WMS-ⅢSST）、霍普金斯词汇学习测验-修订版（HVLT-R）、简单视觉空间记忆测验-修订版（BVMT-R）分别对工作记忆、言语记忆和视觉记忆领域进行评定。结果在治疗前,两组的WMS-ⅢSST HVLT-R和BVMT-R得分比较均无统计学意义（P〉0.05）。在治疗12周后,两组的HVLT-R和BVMT-R得分较治疗前比较均有统计学意义（P〈0.05）而治疗后两组间比较无统计学意义（P〉0.05）;阿立哌唑组在治疗后的WMS-ⅢSST得分较治疗前显著增加（P〈0.05）,且治疗后两组间比较有统计学意义（P〈0.05）,而利培酮治疗前后WMS-ⅢSST得分比较无统计学意义（P〉0.05）。结论阿立哌唑和利培酮对首发精神分裂症患者记忆功具有改善作用,阿立哌唑对某些记忆功能改善优于利培酮。     

阿立哌唑合并艾司西酞普兰治疗精神分裂症阴性症状对照研究

目的探讨阿立哌唑合并艾司西酞普兰治疗阴性症状为主的精神分裂症患者的疗效及安全性。方法将72例以阴性症状为主的精神分裂症患者随机分为两组各36例,研究组口服阿立哌唑合并艾司西酞普兰治疗．对照组口服阿立哌唑合并安慰剂治疗,观察12周,于治疗前及治疗2、4、6、8、12周末采用阳性与阴性症状量表（PANSS）和副反应量表（TESS）评定临床疗效及不良反应。结果12周末研究组的疗效与对照组无显著性差异,但12周末研究组阴性症状因子分的显著低于对照组（P〈0．01）。两组主要不良反应为轻度失眠、头痛、恶心、锥体外系反应、食欲下降等。结论阿立哌唑合并艾司西酞普兰治疗能显著缓解阴性症状,且不良反应发生率低。     

Aripiprazole in schizophrenia and schizoaffective disorder: A review

Background: During the past decade, there has been some progress in the pharmacotherapy of schizophrenia and schizoaffective disorder. Current evidence supports the use of various second-generation, or atypical, antipsychotic medications, although few of these agents have been associated with long-term efficacy and tolerability. Aripiprazole is an atypical antipsychotic that has been found to improve positive and negative symptoms of schizophrenia with a favorable adverse-effect profile.Objective: This article reviews the efficacy and tolerability of aripiprazole in the context of recommended management strategies for schizophrenia and schizoaffective disorder, and in comparison with first-generation and other second-generation antipsychotics.Methods: A search of MEDLINE (1999–May 2009) was conducted for reports of short- and long-term clinical studies of atypical antipsychotics (including aripiprazole) and meta-analyses of randomized controlled trials comparing first- and second-generation antipsychotics (including aripiprazole) in the treatment of schizophrenia or schizoaffective disorder. The search terms were schizophrenia; schizoaffective disorder; pharmacogenetics; adverse effects; tardive dyskinesia AND atypical antipsychotics; aripiprazole; aripiprazole, schizophrenia, AND double-blind studies; and atypical antipsychotics AND adverse effects. The reference lists of identified articles were reviewed for additional relevant publications. Only full study publications were included.Results: Based on the clinical evidence, including data from short-term (4–8 weeks) and long-term (26–52 weeks) randomized, double-blind clinical trials, aripiprazole has been associated with improvements in positive, negative, cognitive, and affective symptoms of schizophrenia and schizoaffective disorder. It has been associated with long-term (up to 52 weeks) symptom control in schizophrenia, as well as with efficacy in treatment-resistant schizophrenia. Common adverse effects associated with aripiprazole were nausea, insomnia, and agitation. These effects were usually transient. The evidence suggests that aripiprazole is unlikely to be associated with clinically significant weight gain or dyslipidemia, increased prolactin levels, or prolongation of the QTc interval. Compared with placebo, aripiprazole has been reported to have a relatively low potential for inducing metabolic syndrome.Conclusions: Based on the evidence reviewed, aripiprazole monotherapy appears to be effective and well tolerated in treating the positive, negative, and cognitive symptoms of schizophrenia and schizoaffective disorder. It was associated with a low risk for the common adverse effects of antipsychotic therapy, including metabolic and endocrine alterations.     

Risperidone versus haloperidol in the treatment of schizophrenia: a meta-analysis comparing their efficacy and safety

The aim of this study was to compare the shortterm clinical efficacy and safety of risperidone with haloperidol and placebo. A meta-analysis of seven published randomized double-blind controlled trials was carried out. Study quality was assessed. The proportion of patients failing to reach at least 20% improvement on the positive and negative syndrome scale (PANSS) or brief psychiatric rating scale (BPRS), the proportion of patients discontinuing treatment because of adverse effects and the number of patients who needed antiparkinsonian medication were abstracted for use as outcome measures.
Treatment failure was present in 50% of risperidone-treated patients compared to 66% in those treated with haloperidol and 83% in those treated with placebo. It would be necessary to treat 11 patients with risperidone to prevent one treatment failure in those patients treated with haloperidol (Odds ratio (OR) = 0.74, 95% CI of 0.58-0.94, P =0.02). Pooling of the three multicentre trials which included placebo as a treatment arm, showed that one in three patients treated with risperidone 4–16 mg/day (OR=0.22, 95% CI of 0.13-0.39, P <0.00001) and one in six treated with haloperidol 10–20 mg/day (OR=0.44, 95% CI of 0.22-0.84, P =0.02) would derive significant benefit. Moreover, there was a highly significant greater need for anticholinergic medication due to extrapyramidal symptoms (EPS) in the haloperidol-treated patients compared to risperidone (OR=0.54, 95% CI of 0.42-0.70, P <0.00001). In conclusion, risperidone seems to be more effective and causes less EPS than haloperidol, as suggested by the significantly lower requirement for antiparkinsonian medication.     

Aripiprazole in the treatment of early-onset schizophrenia spectrum disorder: A case series in Korean children and adolescents

Objective: The aim of this case series was to assess the effectiveness and tol-erability of aripiprazole in Korean children and adolescents with early-onset schizophrenia spectrum (EOSS) disorder.Methods: The medical records of aripiprazole-treated patients with EOSS were retrospectively reviewed. Changes in illness severity were measured using the Clinical Global Impression-Severity of Illness (CGI-S) and Clinical Global Impression-Improvement (CGI-I) scales.Results: Data from 22 children and adolescents were included (12 girls, 10 boys; mean [SD] age, 14.0 [2.4] years). The mean (SD) dosage of aripiprazole was 19.8 (9.4) mg/d (median, 18.7 mg/d; mode, 15, 30 mg/d), and the range of treatment duration was 21 to 838 days. Mean (SD) CGI-S score improved significantly from baseline to end point (from 5.7 [0.7] to 4.3 [1.4]; P < 0.001). Based on changes in chart-extracted CGI-I scores, significantly greater improvement was associated with negative symptoms compared with positive symptoms (U = 25.5; P = 0.028; r = −0.47). Aripiprazole was discontinued due to insufficient effect in 5 patients (22.7%) and treatment-emergent adverse events in 3 patients (13.6%).Conclusion: The results from this small study suggest that aripiprazole was moderately effective in reducing psychotic symptoms in these Korean children and adolescents with EOSS.