哌罗匹隆与奋乃静治疗精神分裂症患者60例对照研究

目的：总结分析哌罗匹隆与奋乃静在精神分裂症患者治疗中的疗效差异。方法选择2010-06-2012-11我院收治的60例精神分裂症患者为研究对象,随机分为观察组和对照组各30例,观察组患者给予哌罗匹隆治疗,对照组给予奋乃静治疗,比较2组疗效,同时监测2组患者PRL（血清催乳素）、TSH（促甲状腺激素）、T3（三碘甲状腺原氨酸）、FT3（游离T3）、T4（甲状腺素）、FT4（游离T4）。结果观察组有效率80·00％高于对照组76·67％,差异无统计学意义（P＞0·05）;2组患者PANSS总分和各因子评分都明显优于治疗前（P＜0·05）;治疗后2组TESS评分差异无统计学意义（P＞0·05）。结论哌罗匹隆与奋乃静对精神分裂症患者治疗疗效相当,但哌罗匹隆对患者PRL和T4影响较小,且用药依从性较好。     

哌罗匹隆及利培酮治疗首次发病的老年精神分裂症对照研究

目的:探讨哌罗匹隆治疗老年期首发精神分裂症的疗效及其对体质量、糖脂代谢的影响。方法:72例老年期首发精神分裂症患者随机分为哌罗匹隆组和利培酮组并予以相应的药物治疗8周。治疗前后进行阳性和阴性症状量表(PANSS)、临床总体印象量表(CGI-SI)及治疗中出现的症状量表(TESS)评定,以及体质量、血糖、血脂测定。结果:治疗后哌罗匹隆组总有效率(83.33%)与利培酮组(80.56%)差异无统计学意义(χ2=0.094,P0.05);哌罗匹隆组低密度脂蛋白水平较治疗前明显增加(P0.05);利培酮组体质量、空腹血糖、餐后2 h血糖、血三酰甘油、总胆固醇及低密度脂蛋白水平较治疗前明显增加,高密度脂蛋白水平明显降低(P0.05或P0.01);两组TESS评分差异无统计学意义。结论:哌罗匹隆治疗老年期首发精神分裂症的疗效与利培酮相当,对体质量、糖脂代谢影响较小。     

盐酸哌罗匹隆治疗首发精神分裂症患者的效果及不良反应

目的探讨首发精神分裂症患者接受盐酸哌罗匹隆治疗的临床效果及不良反应。方法将2019年1月～2020年7月接受利培酮治疗的35例首发精神分裂症患者作为对照组,将同期接受盐酸哌罗匹隆治疗的35例首发精神分裂症患者作为观察组,对组间阳性和阴性症状量表(PANSS)评分、社会功能、血清泌乳素(PRL)、临床治疗效果、不良反应展开分析。结果 (1)组间PANSS评分在治疗前无明显差异;治疗8周后,两组PANSS评分均降低,且组间PANSS评分无明显差异(P0.05);(2)组间社会功能评分在治疗前无明显差异;治疗8周后,观察组社会性退缩、职业和工作、兴趣关心评分低于对照组(P0.05);(3)组间PRL在治疗前无明显差异;观察组治疗第3周、第8周时的PRL水平均低于对照组(P0.05);(4)治疗8周后,观察组3例无效(8.57%),对照组5例无效(14.29%),两组疗效相当(P0.05);(5)观察组的不良反应为5.71%,低于对照组的22.86%(P0.05)。结论盐酸哌罗匹隆与利培酮治疗首发精神分裂症患者的疗效相当,均能改善患者阳性和阴性症状,但是盐酸哌罗匹隆更好的改善患者的社会功能,不良反应更少,对PRL影响更小。     

哌罗匹隆联合艾司西酞普兰治疗阴性症状为主的精神分裂症临床观察

目的探讨哌罗匹隆联合艾司西酞普兰治疗以阴性症状为主的精神分裂症临床疗效。方法选取以阴性症状为主的精神分裂症患者60例,随机分为研究组(n=30)与对照组(n=30)。研究组给予哌罗匹隆联合艾司西酞普兰治疗,对照组给予哌罗匹隆治疗。观察8周,于治疗前、治疗后2、4、8周末采用PANSS量表、阴性症状量表(SANS)、不良反应量表(TESS)评定疗效及不良反应。结果研究组总有效率76.7%,对照组为53.3%比较,差异有统计学意义(P0.05)。研究组在治疗2周末SANS量表评分下降较显著(P0.01)。与治疗前相比,治疗8周末2组PANSS量表评分均显著下降(P0.05),TESS评分无明显差异(P0.05)。结论哌罗匹隆联合艾司西酞普兰治疗以阴性症状为主的精神分裂症起效快,疗效好。     

奥氮平、奎硫平与阿立哌唑对精神分裂症患者血清甲状腺激素和催乳素水平的影响

目的:探讨非典型抗精神病药奥氮平、奎硫平、阿立哌唑对精神分裂症患者血清甲状腺激素和催乳素(PRL)水平的影响方法:将150例精神分裂症患者随机分为奥氮平、奎硫平及阿立哌唑组并接受相应的药物治疗8周。治疗前后分别检测血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、总三碘甲状腺原氨酸(T3)、总甲状腺素(T4)、促甲状腺激素(TSH)及PRL水平。结果:治疗后3组血清FT4、T3、T4水平较治疗前明显下降(P均0.01);T4组间主效应有统计学意义(P0.05);治疗后奎硫平组血清T4水平较奥氮平组下降更明显(P0.05);治疗后奥氮平组血清PRL水平明显高于治疗前及奎硫平及阿立哌唑组(P均0.01),并具有交互作用(P0.01)。结论:奥氮平、奎硫平、阿立哌唑都降低甲状腺激素水平,奎硫平更易降低T4水平;奥氮平显著影响血清PRL水平。     

哌罗匹隆与喹硫平治疗首发精神分裂症的临床研究

目的比较哌罗匹隆与喹硫平治疗首发精神分裂症的疗效及安全性。方法将64例首发精神分裂症患者随机分为哌罗匹隆组(研究组)32例,喹硫平组(对照组)32例,分别给予哌罗匹隆和喹硫平治疗,疗程6周。采用阳性与阴性症状量表(PANSS)评定疗效,治疗时出现的症状量表(TESS)评定不良反应。结果治疗6周后两组PANSS评分较治疗前均有显著下降。哌罗匹隆组显效率为65.6%,有效率为78.1%;喹硫平组显效率为62.5%,有效率为75%,两组间疗效差异无统计学意义(P>0.05),两组间TESS评分差异亦无统计学意义。结论哌罗匹隆治疗首发精神分裂症的疗效及安全性与喹硫平相当。     

哌罗匹隆与舒必利治疗精神分裂症的对照研究

目的探讨哌罗匹隆治疗精神分裂症的效果。方法采用随机数字表法将符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)的113例精神分裂症患者分为两组,分别给予哌罗匹隆与舒必利治疗。哌罗匹隆初始剂量8 mg/d,分2次给药,2周内逐渐增至16~48mg/d,舒必利初始剂量200mg/d,分2次给药,2周内逐渐增至600~900mg/d。疗程为8周。采用阳性与阴性症状量表(PANSS)评定疗效,副反应量表(TESS)、实验室检查评定不良副反应。结果经8周治疗,两组PANSS总评分均较治疗前低(P均<0.01)。哌罗匹隆组与舒必利组总有效率分别为77.19%和73.21%,差异无统计学意义(P>0.05),但哌罗匹隆组较舒必利组对阳性症状起效更好更快(P<0.05)。结论哌罗匹隆对精神分裂症的疗效与舒必利相当。     

重复经颅磁刺激联合盐酸哌罗匹隆治疗精神分裂症患者疗效观察及对认知功能和生活质量的影响

目的探讨重复经颅磁刺激联合盐酸哌罗匹隆治疗精神分裂症患者疗效及对患者认知功能和生活质量的影响。方法 94例精神分裂症患者按照随机表法分为观察组47例与对照组47例。对照组采用盐酸哌罗匹隆治疗,观察组在对照组基础上结合重复经颅磁刺激治疗。两组疗程均为12周。结果观察组总有效率(89.36%)高于对照组(70.21%)(P0.05);观察组治疗后PANSS评分低于对照组(t=21.739,P0.05);观察组治疗后LOCAT评分低于对照组(t=21.708,P0.05);观察组治疗后动力和精力、心理社会、症状和不良反应评分低于对照组(t=8.455、5.946、5.447,P0.05);两组不良反应发生率比较无统计学差异(P0.05)。结论重复经颅磁刺激联合盐酸哌罗匹隆治疗精神分裂症患者疗效显著,可明显改善患者认知功能和生活质量。     

盐酸哌罗匹隆治疗精神分裂症的 临床疗效观察

目的 验证盐酸哌罗匹隆治疗精神分裂症的疗效及安全性.方法 将50例精神分裂症患者随机分配到盐酸哌罗匹隆组25例和阿立哌唑组25例进行为期8周的随机双盲对照研究,采用阳性和阴性症状量表(PANSS)和治疗中出现的症状量表(TESS)评定疗效,用副反应记录表评价副反应.结果 治疗8周后两组患者PANSS总分及各因子分,均较...     

利培酮与氯氮平合并哌罗匹隆应用于难治性精神分裂症的疗效对比分析

目的对比分析难治性精神分裂症患者应用利培酮联合哌罗匹隆与氯氮平合并哌罗匹隆的治疗效果。方法随机将我院97例难治性精神分裂症患者分组,两组患者均予哌罗匹隆口服,对照组48例增加氯氮平口服,观察组49例增加利培酮口服,对比两组患者治疗后精神病理症状、认知功能、生活质量及不良事件发生率。结果观察组阳性和阴性综合征量表(PANSS)评分、不良事件发生率低于对照组,重复性成套神经心理状态测验(RBANS)、简明健康测量量表(SF-36)评分及总有效率高于对照组(P0.05)。结论利培酮联合哌罗匹隆能显著改善难治性精神分裂症患者精神症状,促进认知功能恢复,提升生活质量,且安全性高,效果优于氯氮平合并哌罗匹隆。     

The wide variability of perospirone metabolism and the effect of perospirone on prolactin in psychiatric patients

Background

Perospirone was developed in Japan and is used for the treatment of schizophrenia and related illnesses. The authors investigated the relationship between the dosage of perospirone and the plasma levels of perospirone and its active metabolite, ID15036, and also evaluated the impact of the plasma concentrations of perospirone and ID15036 on the plasma prolactin level to examine whether perospirone or ID15036 affected the dopamine D₂ blockade, in psychiatric patients treated with perospirone.

Methods

The subjects consisted of 21 adults treated with perospirone (4–60 mg/day). The plasma perospirone and ID15036 levels were measured in 21 patients and serum prolactin levels were investigated in 10 male patients with schizophrenia.

Results

The plasma ID15036 level was higher than the plasma perospirone, and a positive correlation was observed between the dosage of perospirone and the ID15036 levels (p = 0.032). The 10 male patients showed a positive correlation between the plasma perospirone levels and plasma prolactin levels (r = 0.688, p = 0.028) and between the plasma ID15036 levels and prolactin levels (r = 0.775, p = 0.009).

Conclusion

The plasma levels of ID15036 may have a greater impact on the dopamine D₂ blockade than perospirone in patients treated with perospirone.     

Contribution of perospirone and risperidone to reduce delirium in senile patients

Background: Serotonin–dopamine antagonists (SDAs) inhibit dopaminergic transmission in the mesolimbic system less than in the nigrostriatal dopaminergic pathway, which relates to the extrapyramidal side‐effects of these drugs. The SDAs seem to have an adequate receptor binding profile for the management of the behavioral and psychiatric symptoms of dementia. However, clinicians are discouraged from prescribing SDAs for elderly patients because of an advisory statement from the US Food and Drug Administration that warns about an increased mortality rate among elderly patients treated with atypical antipsychotics. Methods: We conducted a retrospective study involving 16 elderly patients (mean age 84.9 years; range 67–94 years) with delirium who were treated with one of two SDAs, namely perospirone (4–12 mg/day) or risperidone (1–2 mg/day). The time‐course of their psychiatric symptoms was assessed using subcategories of the Delirium Rating Scale (DRS) before treatment and on Days 10 and 24 of treatment. Results: Total DRS scores were significantly decreased from baseline in both treatment groups. Both agents led to significant improvements from baseline in psychomotor behavior and lability of mood. Of interest, perospirone decreased hallucinations and delusions and improved sleep–awake cycle disturbances compared with baseline. No serious side‐effects were seen with either drug. Conclusions: Both perospirone and risperidone are effective in the management of delirium in elderly patients. The improvement in the sleep–awake cycle with perospirone may be derived from its short pharmacological half‐life.     

Efficacy of perospirone in the management of aggressive behavior associated with dementia

We assessed the efficacy of the serotonin dopamine antagonist, perospirone (PER) on aggressive and agitated behavior in demented patients. Eighteen outpatients with dementia diagnosed according to the DSM-IV were enrolled in this study, and their behavioral symptoms and cognitive impairments were assessed with the Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) and Mini-Mental State Examination (MMSE) instruments for a period of 6 weeks. The maximum benefit of PER was achieved at a mean dose of 7.4 mg/day. Post-hoc analysis showed significant improvement in verbal outbursts after 4 weeks and in agitation scores after 4 and 6 weeks. Only 2 patients dropped out of the study, because of adverse effects, and no serious adverse effect was observed. The data suggest that PER is effective in improving aggressive and agitated behavioral symptoms in demented patients and that it is safe to use in elderly patients.     

A case of neuroleptic malignant syndrome induced by perospirone

Neuroleptic malignant syndrome （NMS） is a rare but life-threatening condition induced by neuroleptic medications. Its main symptoms include the rapid onset of fever, severe extrapyramidal symptoms, autonomic nervous system dysfunction, and impaired consciousness. In severe cases, acute renal failure and circulatory failure can develop, which can rapidly lead to death. In this case report, we discuss the etiology, pathophysiology and management of this condition in a female patient with NMS induced by perospirone. The case highlights the need for clinicians to be vigilant：rapid identification of NMS and vigorous symptomatic treatment of NMS symptoms is the key to decreasing the case-fatality of this rare but serious adverse reaction to antipsychotic medications.     

Beneficial effects of perospirone on aggressive behavior associated with dementia

The aim of this study was to assess the efficacy of the serotonin-dopamine antagonist perospirone in treating aggressive and agitated behavior in patients with dementia. Six patients were referred to the outpatient clinic of Ishizaki Hospital and were followed for 6 weeks. Their psychiatric diagnoses were made using the DSM-IV. Their behavioral symptoms and degrees of cognitive impairment were measured using the Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) and the Mini-Mental Examination State. The changes in BEHAVE-AD scores were investigated. Maximum benefit was achieved at a mean perospirone dose of 9.0 mg/day. No patient experienced severe adverse effects. Post-hoc analysis showed significant improvement in the total BEHAVE-AD and aggressiveness subscale scores within 2 weeks. This study suggests that perospirone is effective in improving aggressive and agitated behavioral symptoms in demented patients and is safe to use in elderly patients.     

Effect of carbamazepine on the single oral dose pharmacokinetics of perospirone and its active metabolite

Perospirone is a serotonin 5-HT(2A) and dopamine D(2) receptor antagonist which originated in Japan. It has been shown that perospirone is metabolized to ID-15036 mainly by CYP3A4 based on an in vitro study. To investigate the metabolism of perospirone in humans, the authors measured the concentration of perospirone and ID-15036 after a single oral dose of perospirone (8 mg) in 10 healthy male subjects, before and during coadministration of carbamazepine, known as a potent inducer of CYP3A4. Before carbamazepine coadministration, the peak plasma concentrations+/-SD of perospirone and ID-15036 were 4.0+/-4.3 and 11.7+/-7.1 ng/ml, respectively. During carbamazepine coadministration, the concentration of perospirone was decreased below the detection limit, and that of ID-15036 was 6.0+/-1.7 ng/ml. The concentrations of perospirone and ID-15036 were influenced significantly by the treatment with carbamazepine, and this was probably attributable to the induction of CYP3A4. This study provided an in vivo evidence of involvement of CYP3A4 in the metabolism of perospirone.     

Augmentation of antidepressants with perospirone for treatment-resistant major depressive disorder

We examined the efficacy and tolerability of perospirone, a dopamine D2 and 5-HT2A receptor antagonist and a partial 5-HT1A receptor agonist, in the augmentation of antidepressant treatment of partially responding and nonresponding patients with major depressive disorder. Twelve patients with major depressive disorder and an incomplete or no response to different kinds of antidepressants (selective serotonin reuptake inhibitor, milnacipran, or sulpride) monotherapy or polytherapy for 8 weeks or more were treated with perospirone augmentation in an eight-week, open-label study. Data were gathered from July 2006 to March 2008. The mean duration of antidepressant pharmacotherapy at baseline was 28 weeks. At baseline, the mean (± SD) of the MADRS scores was 35.8 ± 10.1. The mean (± SD) initial dose of perospirone was 7.0 ± 2.9 mg/day and the final dose was 11.7 ± 6.6 mg/day. Significant reductions in MADRS scores were observed at weeks 2, 4, 6 and 8. Although two of the twelve subjects who completed the protocol achieved remission by the study endpoint, five of the twelve patients were responders (i.e., > 50% improvement in the MADRS score). Sleepiness and tremor were observed in six patients and one patient, respectively, resulting in a reduction of perospirone dose due to these side effects. The discontinuation rate after 8 weeks of treatment was zero. These findings suggest that perospirone may be an effective augmentation strategy for improving therapeutic response in patients with treatment-resistant major depressive disorder when administered in combination with standard antidepressant therapy. Based on this clinical evidence, a double-blind, placebo-controlled trial is warranted.