棕榈酸帕利哌酮长效针剂对精神分裂症患者认知和社会功能改善及内分泌代谢的影响

目的 探讨棕榈酸帕利哌酮长效针剂对精神分裂症患者认知和社会功能改善及内分泌代谢效果。方法 选择120例惠州市第二人民医院收治的精神分裂症患者为对象,研究开始、结束时间分别为2021年7月、2022年7月。随机分为对照组、试验组,各60例。对照组口服利培酮治疗,试验组采用棕榈酸帕利哌酮长效针剂治疗。分别在入组时、6、12个月评价各项指标并检测内分泌指标。结果 入组时,两组患者PANSS各症状评分差异无统计学意义,P> 0.05。入组6、12个月时,试验组患者阳性、阴性症状评分、一般精神病理评分和总分均低于对照组,差异有统计学意义,P <0.05。入组6个月、12个月时,两组TSEE评分比较差异有统计学意义,P <0.05。入组时,两组患者PSP、MoCA评分差异无统计学意义,P> 0.05。入组6、12个月时,试验组患者PSP、MoCA评分均高于对照组,差异有统计学意义,P <0.05。入组时两组患者血糖、血脂（总胆固醇、三酰甘油）、血清泌乳素差异无统计学意义,P> 0.05。入组6、12个月时,试验组患者血糖、血脂（总胆固醇、三酰甘油）、血清泌乳素均...     

棕榈酸帕利哌酮与癸酸酯氟哌啶醇长效针剂治疗首发精神分裂症患者随机对照研究

目的 评估棕榈酸帕利哌酮与癸酸酯氟哌啶醇长效针剂治疗首次发作精神分裂症的临床疗效和安全性.方法 随机抽取门诊或住院92例首发精神分裂症患者,利用随机数字表法分为研究组(棕榈酸帕利哌酮长效针剂)与对照组(癸酸酯氟哌啶醇长效针剂),治疗前及治疗后3,6,9,12个月阳性与阴性症状量表(PANSS)及总分评定疗效,同时采用不...     

棕榈酸帕利哌酮长效剂治疗精神分裂症的随机对照观察

目的:观察棕榈酸帕利哌酮长效剂(PP)治疗精神分裂症的疗效.方法:采用随机数字表法,将110例精神分裂症患者分为PP组(55例,PP治疗12个月)和利培酮组(55例,利培酮治疗12个月),比较两组临床症状及安全性.结果:治疗前,两组患者PANSS各项及总分比较,差异无统计学意义(P>0.05);治疗1个月,两组患者TE...     

不同剂型棕榈酸帕利哌酮治疗精神分裂症有效性及安全性分析

目的 比较1个月注射1次的棕榈酸帕利哌酮注射液（PP1M）与3个月注射1次的棕榈酸帕利哌酮注射液（PP3M）在有效性和安全性方面的差异。方法 检索中国知网、万方数据知识服务平台、PubMed、Embase、the cochrane Library等数据库中关于PP1M与PP3M有效性及安全性比较研究的文献,检索时间为数据库建库至2023年11月。结果 共纳入10篇文献,研究对象均为成人精神分裂症患者,研究周期7～24个月。结果显示,PP1M和PP3M对于精神分裂症患者的症状改善程度相似,PP3M比PP1M更能降低因精神疾病住院率和疾病复发风险,使用PP3M发生锥体外系综合征和体质量增加的风险低于PP1M,其他安全性指标在二者之间没有明显区别。结论 PP1M和PP3M的疗效与安全性相当,PP3M用药依从性更好。     

帕利哌酮棕榈酸盐的临床研究进展

帕利哌酮棕榈酸盐是一种非典型抗精神病药物的长效针剂,活性成分为帕利哌酮,也称9-羟利培酮,主要通过阻断5-羟色胺2A受体和多巴胺D2受体发挥抗精神病药作用。该药在制备过程中采用了特殊的纳米晶体技术,有效提高药物溶解度,使得药物在使用过程中更加安全有效。经试验证实,帕利哌酮棕榈酸盐对精神分裂症急性期治疗和维持治疗效果较好,与现有长效针剂相比具有一定优势,为精神分裂症患者的治疗提供了一种新的选择。     

棕榈酸帕利哌酮长效注射剂仿制药药学研究探究

长效注射剂已逐渐用于抗精神分裂症治疗,棕榈酸帕利哌酮长效注射剂有效控制药物释放,有良好的安全性、临床治疗效果和明显的临床优势,可以一定程度上提高患者依从性。本文通过检索相关国外审评报告和文献资料,概述国内外上市申报的棕榈酸帕利哌酮长效注射剂情况,对此类药物的药学研究进行探讨,提出关注处方工艺和质量控制等研究的考虑,为其研究开发提供一定的参考。     

棕榈酸帕利哌酮治疗大学生精神分裂症40例

目的探讨棕榈酸帕利哌酮长效针剂对大学生精神分裂症患者疗效、安全性、治疗依从性、痊愈率和复发率的影响。方法 80例大学生精神分裂症患者口服利培酮治疗6周待病情稳定后(PANSS≤70分),采用随机数字表法随机分为口服利培酮组(简称口服组,n=40)和棕榈酸帕利哌酮长效注射剂组(简称长效注射剂组,n=40)进行12个月的治疗随访。评估分组前和分组后1,3,6,9和12个月的阳性和阴性症状量表(PANSS)、不良反应量表(TESS)、个人和社会功能评分(PSP)量表、用药满意度问卷(MSQ)以评定疗效、安全性、社会功能和用药满意度,同时比较两组患者的痊愈率、停药率、复发率和再住院率。结果长效注射剂组40例患者中,有36例(90.0%)完成研究,口服组40例患者中,有29例(72.5%)完成研究。长效注射剂组TESS、PSP和MSQ评分均优于口服组(P<0.05)。长效注射剂组临床痊愈率为41.6%,高于口服组23.3%(P<0.05)。长效注射剂组4例停药(10.0%)、3例复发(7.5%)和1例再住院(2.5%),口服组11例停药(27.5%)、10例复发(25.0%)和8例再住院(20.0%)。结论棕榈酸帕利哌酮长效针剂能改善社会功能和用药满意度,提高治疗依从性和临床痊愈率,降低停药率、复发率和再住院率,能安全有效地用于大学生精神分裂症患者的院外长期维持治疗。     

棕榈酸帕利哌酮注射液治疗老年精神分裂症的有效性及安全性分析

目的:探讨棕榈酸帕利哌酮注射液治疗老年精神分裂症患者的疗效、耐受性、安全性及社会功能的恢复.方法:将天津市安定医院2014年8月-2016年3月老年科收治的80例老年精神分裂症患者随机分为研究组和对照组,每组40例患者.研究组用棕榈酸帕利哌酮注射液治疗,第1日注射75 mg,第8日注射75 mg,此后每隔1个月左右注射50~75 mg;对照组用利培酮片剂治疗,第1日口服0.5 mg,在2周内逐步增量至最佳给药剂量,最大给药剂量不超过2 mg/d,疗程24周.治疗前及治疗后4、8、16和24周采用阳性和阴性症状量表(PANSS)、依从性评定量表(MARS)、副反应量表(TESS)来评估疗效及安全性,用个人和社会功能量表(PSP)来评估社会功能.结果:72例患者完成24周临床治疗,有8例患者脱落.①两组PANSS评分在治疗第4、8、16和24周时均低于基线水平,差异均有统计学意义(P均<0.01);两组间同一时点PANSS评分比较,差异均无统计学意义(P均>0.05).②研究组MARS评分在治疗第4、8、16和24周均高于基线水平,差异均有统计学意义(P均<0.01);对照组MARS评分在治疗第4、8周均有显著统计学意义(P均<0.05);两组间除基线外同一时点MARS评分比较,差异均有统计学意义(P均<0.01).③研究组同一治疗时点PSP评分均高于对照组,且差异均有统计学意义(P均<0.01);对照组PSP评分在治疗第4、8、16和24周均高于基线水平,差异有统计学意义(P均<0.05);两组间除基线外同一时点PSP评分均高于对照组,差异均有统计学意义(P均<0.05).④两组患者均无严重不良反应发生,组间不良反应发生率比较差异无统计学意义(P均>0.05).结论:老年精神分裂症患者采用棕榈酸帕利哌酮注射液治疗疗效与利培酮片剂相当,但服药依从性好,社会功能明显恢复,无明显不良反应.     

难治性双相障碍混合发作患者换帕利哌酮缓释片社会功能满意度调查

目的:探讨难治性双相障碍混合发作患者换用帕利哌酮缓释片对社会功能及满意度的影响.方法:选取2019年1至6月期间120例难治性双相障碍混合发作患者作为研究对象,将其分为两组,研究组60例,换用帕利哌酮缓释片治疗,对照组60例,换用奥氮平片治疗.治疗8周后,进行抗精神病药物满意度量表(MSQ)、临床总体印象量表(CGI-...     

棕榈酸帕利哌酮注射液治疗冰毒所致精神障碍的临床研究

目的：研究观察棕榈酸帕利哌酮注射液（善思达）对冰毒所致精神障碍的临床疗效,为临床实践和理论研究提供科学依据。方法采用回顾性研究,对福建省某自愿戒毒所2013年6月~2014年6月期间收治的100例冰毒所致精神障碍患者的临床资料进行分析,随机分为实验组与对照组,每组50例。实验组患者使用善思达肌注进行治疗,对照组患者使用利培酮口服治疗,观察两组患者的治疗疗效、服药依从性和治疗的安全性。结果两组间比较：实验组治疗总有效率为96%,对照组治疗总有效率为74%,实验组优于对照组,组间比较有显著性差异（ P<0.05）;治疗后两组PANSS总分及各因子分较治疗前均逐渐下降,治疗前后有显著性差异（P <0.05）;两组间比较：实验组治疗后2、4、8周的PANSS总分及各因子分较对照组下降有显著性差异（P<0.05）;两组患者经过治疗,实验组患者总服药依从率为96%,对照组患者总服药依从率为68%,组间比较有显著性差异（P<0.05）。结论棕榈酸帕利哌酮注射液（善思达）治疗冰毒所致精神障碍临床疗效显著,依从性好,值得临床推广应用。     

Hypothalamic-Pituitary-Adrenal Axis Dysfunction and Illness Progression in Bipolar Disorder

Background:

Impaired stress resilience and a dysfunctional hypothalamic-pituitary-adrenal (HPA) axis are suggested to play key roles in the pathophysiology of illness progression in bipolar disorder (BD), but the mechanisms leading to this dysfunction have never been elucidated. This study aimed to examine HPA axis activity and underlying molecular mechanisms in patients with BD and unaffected siblings of BD patients.

Methods:

Twenty-four euthymic patients with BD, 18 siblings of BD patients, and 26 healthy controls were recruited for this study. All subjects underwent a dexamethasone suppression test followed by analyses associated with the HPA axis and the glucocorticoid receptor (GR).

Results:

Patients with BD, particularly those at a late stage of illness, presented increased salivary post-dexamethasone cortisol levels when compared to controls (p = 0.015). Accordingly, these patients presented reduced ex vivo GR responsiveness (p = 0.008) and increased basal protein levels of FK506-binding protein 51 (FKBP51, p = 0.012), a co-chaperone known to desensitize GR, in peripheral blood mononuclear cells. Moreover, BD patients presented increased methylation at the FK506-binding protein 5 (FKBP5) gene. BD siblings presented significantly lower FKBP51 protein levels than BD patients, even though no differences were found in FKBP5 basal mRNA levels.

Conclusions:

Our data suggest that the epigenetic modulation of the FKBP5 gene, along with increased FKBP51 levels, is associated with the GR hyporesponsiveness seen in BD patients. Our findings are consistent with the notion that unaffected first-degree relatives of BD patients share biological factors that influence the disorder, and that such changes are more pronounced in the late stages of the illness.     

Paliperidone extended-release: a review of efficacy and tolerability in schizophrenia,schizoaffective disorder and bipolar mania

Importance of the field: Paliperidone extended-release (ER), a once-daily, oral, atypical antipsychotic, has been available in the USA and the EU for the treatment of schizophrenia for more than 2 years and was recently (July 2009) approved in the USA for treatment of schizoaffective disorder. Additional data on its efficacy and safety, including that for additional indications, is emerging.

Areas covered in this review: This review provides a background on the compound and summarizes recent data available on treatment of schizophrenia, including comparative data with other antipsychotics, and efficacy and safety data from clinical trials in schizoaffective and bipolar disorders.

What the reader will gain: The reader will gain knowledge of the compound and the existing clinical data so far for paliperidone ER.

Take home message: Paliperidone ER is effective for the treatment of schizophrenia and is at present the only antipsychotic approved in the USA for treatment of schizoaffective disorder. Its efficacy and tolerability profile in treating patients with schizophrenia or schizoaffective disorder indicates that paliperidone ER offers an important treatment option among atypical antipsychotic therapy for these patients.     

帕利哌酮联合中成药治疗脑外伤所致精神障碍36例

目的 探讨帕利哌酮联合中成药治疗脑外伤所致精神障碍的临床疗效及安全性。方法 将72例脑外伤致精神障碍患者随机分为对照组和观察组,各36例。对照组给予帕利哌酮缓释片治疗,观察组在对照组基础上加用黄芪注射液和血府逐瘀胶囊。于治疗前及治疗后2,4,6,8周末采用阳性与阴性症状量表（PANSS）进行评分,观察临床疗效,监测帕利哌酮的起效时间、用药剂量,记录不良反应。结果 治疗8周后,观察组总有效率为97.22%,明显高于对照组的86.11%（P〈0.05）;观察组PANSS总分及各因子分与对照组相比均有显著下降（P〈0.05）,观察组平均起效时间短于对照组,帕利哌酮日平均剂量少于对照组,不良反应发生率低于对照组,差异均有统计学意义（P〈0.05）。结论 帕利哌酮联合中成药治疗脑外伤后伴躁狂的精神障碍,疗效确切,起效更快,控制症状更迅速,用药剂量少,不良反应少,值得临床推广。     

帕利哌酮缓释片对酒精所致精神病性障碍患者精神症状及生活质量的疗效观察

目的 探讨帕利哌酮缓释片对酒精所致精神病性障碍患者精神症状及生活质量的疗效及安全性。方法 收集50例酒精所致精神病性障碍患者,随机分为研究组和对照组,研究组使用帕利哌酮缓释片,对照组使用氟哌啶醇片,研究时间为6周,运用阳性与阴性症状量表(PANSS)、生活质量指数问卷(QL-Index)和副反应量表(TESS)对2组患者进行疗效及不良反应的评定。结果 研究组有效率为72%,显著高于对照组的60%(P<0.05)。研究组PANSS评分在入组后第1周较入组时有显著性下降,QL-Index评分在入组后第1周较入组时有显著提高(P<0.05)。与对照组相比,研究组PANSS评分在入组后第1周阳性分及总分显著降低,在入组后第2,4,6周时阳性分、阴性分及总分均显著降低(P<0.05);QL-Index评分在入组后第1,2,4,6周时均显著升高;研究组TESS评分在入组后第1,2,4,6周时均显著降低。结论 帕利哌酮缓释片在改善酒精所致精神病性障碍患者精神症状、生活质量及安全性等方面优于氟哌啶醇。     

奎硫平与丙戊酸钠缓释片治疗双相障碍躁狂发作对照研究

目的 观察奎硫平与丙戊酸钠缓释片治疗双相障碍躁狂发作的疗效和安全性.方法 利用随机对照方法,将103例双相情感障碍躁狂发作患者分为奎硫平组51例和丙戊酸钠缓释片组52例.观察疗程均为6周,于治疗前以及治疗2,4,6周末采用Young躁狂评定量表、阳性和阴性症状量表(PANSS)评定临床疗效.结果 Young躁狂评定量表减分值比较显示,奎硫平组有效率为70.59%,丙戊酸钠组有效率为71.15%,疗效相近(P＞0.05),但奎硫平组治疗2周末Young躁狂评定量表减分较丙戊酸钠缓释片组下降更快(P＜0.05);两组不良反应发生率无显著差异性(P＞0.05).丙戊酸钠组的脱落率大于奎硫平组.结论 奎硫平治疗双相情感障碍躁狂发作与丙戊酸钠缓释片治疗效果相同,安全性高,起效更快,更适合躁狂急性期的治疗.     

Differentiating Between the Course of Illness in Bipolar 1 and Chronic-Psychotic Heroin-Dependent Patients at Their First Agonist Opioid Treatment

In an effort to inquiry the “self-medication hypothesis” in heroin-dependent patients suffering from chronic psychosis and bipolar disorder, a naturalistic comparative cohort study was designed with the aim of comparing, according to the presence of dual diagnosis, the clinical characteristics of heroin-dependent patients presenting for their first agonist opioid treatment. The main finding was that addictive (heroin) illness was more severe in bipolar 1 patients and less severe in chronic psychotic patients when compared with heroin-dependent patients without dual diagnoses. In the case of chronic psychotic patients, these differences do not allow us to exclude a therapeutic heroin use, at least at the beginning of their toxicomanic career, with limited progression of their addictive disease. This occurrence seems to be excluded for bipolar 1 heroin-dependent patients, who come to their first agonist opioid treatment with a more severe addictive disease.     

帕利哌酮缓释片对精神分裂症患者急性期的个人和社会功能影响

目的观察帕利哌酮缓释片对精神分裂症急性期患者个人和社会功能的影响。方法将85例精神分裂症患者随机分为帕利哌酮组(43例)与利培酮组(42例),疗程6周。并采用阳性与阴性症状量表(PANSS)、临床总体印象量表(CGI)、个人和社会功能量表(PSP)中文版(PSP-CHN)评定。结果治疗6周后,帕利哌酮组的早期疗效优于利培酮组,但2组总体疗效相当;而帕利哌酮组PSP评分以及对社会中有用的活动、个人和社会关系、自我照料三项维度的改善优于利培酮组。结论帕利哌酮缓释片对治疗精神分裂症急性期患者的疗效显著,并能全面改善患者的个人和社会功能。     

Risperidone long-acting injection as monotherapy and adjunctive therapy in the maintenance treatment of bipolar I disorder

Importance of the field: It is very rare for patients with bipolar disorder to have a single episode of mania or depression over a lifetime and the vast majority of these individuals need long-term prophylactic/maintenance treatment. However, treatment nonadherence is a major issue for close to half of subjects with bipolar disorder who are prescribed medications. Risperidone long-acting injection (LAI) has proven efficacious for the maintenance phase of bipolar disorder and may mitigate the problem of nonadherence in the substantial group of patients for whom this is a significant concern.

Areas covered in this review: This paper comprises a review and commentary regarding the use of risperidone LAI in bipolar disorder.

What the reader will gain: The reader will gain an understanding regarding the risks and benefits of risperidone LAI in bipolar disorder. We review the available evidence and discuss the strengths and weaknesses of published studies, providing an opinion about the clinical usefulness of risperidone LAI as well as suggestions for future research.

Take home message: The use of risperidone LAI, through improved adherence, has the potential to ameliorate the course of bipolar disorder.     

Monocyte and Lymphocyte Activation in Bipolar Disorder: A New Piece in the Puzzle of Immune Dysfunction in Mood Disorders

Background:

This study tested the hypothesis that the low-grade inflammation presented in patients with bipolar disorder (BD) is associated with expansion of activated T cells, and this activated state may be due to a lack of peripheral regulatory cells.

Methods:

Specifically, we investigated the distribution of monocytes and lymphocyte subsets, and investigated Th1/Th2/Th17 cytokines in plasma by flow cytometry. Twenty-one BD type I patients and 21 age- and sex-matched controls were recruited for this study.

Results:

BD patients had increased proportions of monocytes (CD14+). Regarding lymphocyte populations, BD patients presented reduced proportions of T cells (CD3+) and cytotoxic T cells (CD3+CD8+). BD patients also exhibited a higher percentage of activated T CD4+CD25+ cells, and a lower percentage of IL-10 expressing Treg cells.

Conclusions:

Our data shed some light into the underlying mechanisms involved with the chronic low-grade inflammatory profile described in BD patients.