住院老年精神分裂症患者抗精神病药物用药情况调查分析

目的:了解我院老年精神分裂症患者抗精神病药物使用情况.方法:对住我院84例住院老年精神分裂症患者使用抗精神病药物治疗情况进行调查.结果:单一用药76例,占90.48%,两种药物联用7例,占8.33%.按照单一药物应用频度排列前5位的是利培酮、氯氮平、奋乃静、喹硫平、氯丙嗪.结论:抗精神病药物使用多样化,剂量个体化.     

精神分裂症住院患者使用抗精神病药情况分析

目的探讨精神分裂症住院患者抗精神病药使用情况。方法样本采取整群人组,横断面调查方法,符合中国精神疾病分类与诊断标准第3版(CCMD-3)精神分裂症的患者,共476例,调查其用药情况。结果临床药物治疗以单一用药为主(占64.3%),氯氮平使用比例较高(占27.8%);首次发病及病程短于5年的患者使用新型抗精神病药相对较多(分别为68.4%及77.8%)。结论传统抗精神病药物仍为目前的主流治疗药,且以氯氮平居多;新型抗精神病药所占比例虽低于发达国家,但呈逐年上升趋势,且以利培酮为多数。     

盐城市第四人民医院住院老年精神分裂症患者抗精神病药物用药情况调查

目的分析盐城市第四人民医院住院老年精神分裂症患者抗精神药物使用情况,以期指导临床合理用药。方法回顾性分析2013年1月-2014年12月医院1061例老年抗精神药物使用情况,比较2年抗精神药物使用变化。结果 2年内联合用药比例分别是44.51%、43.23%,联合用药比例有所降低;从用药频率来看,目前主要抗精神药物是奥氮平(23.28%)、利培酮(20.45%)、喹硫平(17.15%)、阿立哌唑(7.72%),用药剂量分别为(13.4±2.2)mg/d、(2.6±0.6)mg/d、(345.5±43.4)mg/d、(11.5±2.1)mg/d。结论就目前来看,老年类抗精神药物单一用药还是占主导,且以非典型抗精神病药物为主,用药剂量均较小。     

流浪精神分裂症患者抗精神病药物使用的性别差异

目的调查我院流浪精神分裂症患者抗精神病药物使用的性别差异。方法采用一日法,以2012年2月18日为时间节点,对我院流浪精神分裂症住院患者(男159例,女111例)的治疗情况进行对比研究。结果①单一使用抗精神病药物:占首位(男性为57.2%,女性为79.3%);联用两种以上抗精神病药物者男性为42.8%,女性为20.7%,男性明显多于女性,差异有统计学意义(P<0.001)。②男性使用抗精神病药物排在前3位的是:利培酮,氯丙嗪,舒必利;女性使用抗精神病药物排在前3位的是:利培酮,氯氮平,氯丙嗪;无重大剂量用药者。③抗精神病药物日均剂量折算为氯丙嗪剂量后,男性与女性比较差异无统计学意义(P>0.05)。结论本调查提示,目前,我院流浪精神分裂症患者抗精神病药物的使用情况比较规范合理,在联合用药方面及部分药物使用频度方面存在性别差异,日均剂量方面性别差异无统计学意义。     

老年精神病患者抗精神病药物使用情况调查分析

目的了解该中心老年精神病患者用药特点,以指导临床合理用药。方法对≥60岁的135例精神病患者的病历资料进行分析。结果 135例患者中,未用任何抗精神病药物者53例（39.26%）,应用抗精神病药物者82例（50.74%）其中单独用1种精神药物60例（73.17%）,联用2种者22例（26.83%）,未发现联用3种或以上的情况。精神分裂症患者用药日剂量与情感性精神障碍比较差异无统计学意义（P〉0.05）,与阿尔茨海默病、脑血管病所致精神障碍、慢性乙醇中毒所致精神障碍及躯体疾病所致精神障碍比较差异均有统计学意义（P〈0.01或P〈0.05）。男患者平均日剂量为（6.80±7.28）mg,女患者平均日剂量为（7.01±5.61）mg,差异无统计学意义（P〉0.05）。结论老年期精神障碍患者使用抗精神病药物药物应谨慎,做到安全、有效、经济、必需,定期对住院患者药物使用情况进行调查研究分析,有助于药物的合理使用。     

精神分裂症住院患者应用抗精神病药1日调查分析

目的:了解山东淄博市精神卫生中心精神分裂症住院患者抗精神病药应用情况。方法:采用1日法对住院精神分裂症患者抗精神病药的应用状况进行调查。结果:临床药物治疗以单一用药为主(62.96%);氯氮平的使用频率排在首位;抗精神病药的使用剂量基本都在推荐的安全剂量之内。结论:我院抗精神病药使用基本合理,但还存在一些不足之处,应对药物的使用情况进行定期调查,提高合理用药水平。     

住院精神分裂症患者抗精神病药物应用状况和变化趋势探究

目的：分析2013年住院精神分裂症患者抗精神病药物应用状况和变化趋势。方法以2013年收治的237例精神分裂症患者的住院病历作为研究对象,拟定调查表收集患者的个人信息、疾病临床特点与药物使用情况等资料。结果2013年中常用的抗精神病药物片剂依次为喹硫平片179136粒、舒必利片92948粒、氯氮平片69160粒、奋乃静片59069粒、利培酮片48489粒、氟哌啶醇片11295粒;注射类药物为氟哌啶醇注射液347支、舒必利注射液154支。患者治疗期间应用最多的是喹硫平片,对比其他抗精神病药物具有显著差异,可见随着药物治疗的发展,抗精神病药物的使用有朝向非典型抗精神病药物发展的趋势。同时,患者抗精神病药物单一使用剂量逐步加大,远大于药物联用时的剂量,差异显著。第二代抗精神病药氯氮平片的使用剂量排列第三,因与其他抗精神病药物联用时易发生不良反应,应引起医护人员的重视。结论2013年抗精神病药物的使用逐步向非典型抗精神病药转型,非典型抗精神病药喹硫平片的使用量相对较大,在日后仍旧扮演着重要“角色”。     

抗精神病药物引发精神分裂症患者糖尿病分析

随着非经典抗精神病药在临床的广泛应用，精神分裂症患者的糖尿病的患病率的增加，日益受到关注。糖尿病是一种常见的糖代谢紊乱为主的内分泌代谢病，严重地影响着患者的身心健康。本文介绍抗精神病药物引发精神分裂症患者并发糖尿病分析。     

不同年代首次住院精神病患者抗精神病药物使用演变

目的：了解不同年代抗精神病药物的使用情况。方法：将1969，1979，1989，1999年武汉精神卫生中心首次住院患者的病历各随机抽取100份，用自制调查表调查诊断及用药情况。结果：氯丙嗪的使用频率逐渐减少，由1969年93%降至1999年32%；氯氮平、舒必利使用频率明显上升，分别由1989年12%上升至1999年54%，22%；抗躁狂药、抗抑郁药使用率明显上升。结论：近30年来抗精神病药物的使用发生了极大变化，这与临床医生对抗精神病药物及精神疾病本质的认识不断加深有关。氯氮平因安全有效，已成为临床最浑用的抗精神病药物。     

Advantages and problems in the use of performance tests to study schizophrenic deficit

Performance measures (such as reaction time, perceptual constancy, or word associations) can conceivably contribute to a better understanding of drug action than can behavior ratings. The reason is that they offer a greater opportunity to define and delineate behavior than do behavior ratings. In spite of a plethora of measures which are presumed to be aspects of schizophrenic deficit, less is known about drug effects on such performance measures than on sympton and behavior ratings. Difficulties with measuring performance deficit in schizophrenia arise when one wishes to separate the effects of practice, test difficulty, motivation to perform, and ability to follow test instructions from the performance function being measured. Few tests have survived or undergone replication studies. Perhaps the single outstanding exception is reaction time. Some tests show that relatively few of the patients have pathological scores. Rarely are the standard psychometric characteristics of these tests reported. The questions before this study group were: (a) What is our ability at the present time to specify some performance deficit measures in schizophrenia; and (b) considering the small number of performance measures that can be included in any single study, what are the research strategies that should be adopted?     

Hypothermia following antipsychotic drug use

Objective Hypothermia is an adverse drug reaction (ADR) of antipsychotic drug (APD) use. Risk factors for hypothermia in ADP users are unknown. We studied which risk factors for hypothermia can be identified based on case reports. Method Case reports of hypothermia in APD-users found in PUBMED or EMBASE were searched for risk factors. The WHO international database for Adverse Drug Reactions was searched for reports of hypothermia and APD use. Results The literature search resulted in 32 articles containing 43 case reports. In the WHO database, 480 reports were registered of patients developing hypothermia during the use of APDs which almost equals the number of reports for hyperthermia associated with APD use (n = 524). Hypothermia risk seems to be increased in the first days following start or dose increase of APs. APs with strong 5-HT2 antagonism seem to be more involved in hypothermia; 55% of hypothermia reports are for atypical antipsychotics. Schizophrenia was the most prevalent diagnosis in the case reports. Conclusion Especially in admitted patients who are not able to control their own environment or physical status, frequent measurements of body temperature (with a thermometer that can measure low body temperatures) must be performed in order to detect developing hypothermia.     

抗精神病药物所致体重增加与多巴胺D2受体基因多态性和治疗效应的关联分析

目的　探讨抗精神病药物 (APS)所致体重增加与多巴胺D2 受体 (DRD2 )基因TaqIA多态性和治疗效应之间有无相关。方法　采用PCR RFLP方法分析 117例首发精神分裂症患者DRD2 基因TaqIA多态性 ,APS(氯丙嗪或利培酮 )单药治疗 10周 ,测定患者治疗前后体重和体重指数 (BMI) ,用阳性和阴性症状量表 (PANSS)评定患者治疗前后精神症状 ,并分析BMI变化值与基因型和PANSS减分率的相关性。结果　治疗后患者平均体重变化 (3 15± 3 47)kg或基础体重的(5 6 9± 6 15 ) % ,体重变化的范围为 - 7kg～ 12kg或 - 7 78%～ 32 43% ;患者年龄和基础BMI明显影响BMI变化值 ,差异有显著性 (P =0 0 3)和非常显著性 (P =0 0 0 0 1) ;A1等位基因和PANSS减分率对BMI变化值的影响差异均无显著性 (P >0 0 5 )。结论　DRD2 基因TaqIA多态性不可能是APS所致精神分裂症体重增加的主要遗传因素 ;体重增加不是APS临床治疗效果的指标。     

住院精神病患者抗精神病药应用现状调查

目的 了解住院精神病患者抗精神病药的应用情况，为临床用药提供参考。方法 抽样调查本院2003年6月508例住院精神病患者抗精神病药应用情况。结果 本次调查共涉及423例患者24种治疗方案，其中单用1种抗精神病药的治疗方案有7种246例(58．15％)，联用2种抗精神病药的有15种173例(40．90％)，联用3种抗精神病药的有1种2例(0．47％)。抗精神病药治疗方案居前5位的依次为：氯氮平、氯氮平 碳酸锂、氯氮平 舒必利、氯丙嗪和利培酮。抗精神病药使用率占前5位的是氯氮平(51．9％)、利培酮(19．29％)、舒必利(17．12％)、氯丙嗪(15．35％)和奋乃静(9．05％)。结论 本院单用1种抗精神病药的治疗方案占主导地位，氯氮平的使用率为第1位。     

A strategy for the study of behavioral mechanisms of antipsychotic drug action in schizophrenia

The basic strategy being proposed is one of studying the time-course of antipsychotic drug effects upon performance measures in parallel with the timecourse of drug effects upon the symptoms of schizophrenia, general morbidity and ward behavior. Critical for the productivity of this strategy is the inclusion of performance measures that reflect functioning in psychological processes—e.g., attention, perception etc., in which schizophrenic-specific deficit or deviance has been demonstrated and which may be presumed to mediate symptom formation. Promising candidates for inclusion in a battery of performance measures under these criteria are those reflecting functioning in the information-processing sequence, i. e., in sensory-attentional-perceptual-cognitive processes. Given this approach, the examination of relationships between patterns of change at the level of deficit performance and of symptomatology, has the potentiality of disclosing both mechanisms of drug action and critical mediating mechanisms of schizophrenic disorder.Paper presented at the meetings of the American College of Neuropsychopharmacology, December 10–11, 1970, San Juan, Puerto Rico, as part of a symposium, Behavioral Mechanisms of Drug Action in Schizophrenia, Solomon C. Goldberg, Chairman.     

抗精神病药物对精神分裂症患者血糖的影响

目的：探讨抗精神病药物对精神分裂症患者血糖的影响。方法选取2012年1月—2014年6月重庆市江北区精神卫生中心收治的精神分裂症患者126例,随机分为A组、B组、C组,各42例。A组患者予以氯丙嗪治疗,B组患者予以阿立哌唑治疗,C组患者予以喹硫平治疗。观察3组患者治疗前（入院时）、治疗第4周、第8周、第12周血糖水平及治疗第12周高血糖发生情况。结果治疗前、治疗第4周、第8周、第12周3组患者血糖水平比较,差异无统计学意义（ P>0.05）, A组患者治疗后第12周血糖水平高于治疗前,差异有统计学意义（ P<0.05）;治疗第12周,B、C组患者高血糖发生率低于A组,差异有统计学意义（ P<0.05）,B、C组患者高血糖发生率比较,差异无统计学意义（ P>0.05）。结论氯丙嗪对精神分裂症患者的血糖影响较大,阿立哌唑和喹硫平对精神分裂症患者血糖的影响较小。     

住院老年精神病患者用药调查与分析

目的了解本院住院老年精神病患者的药物使用情况及药物不良反应。方法采用一日调查法对本院住院老年精神病患者的用药进行调查。结果在参与调查的198例患者中,其中单一用药103例,两药联用68例。在老年精神病患者用药后监测的不良反应中,有110例（55．56％）患者发生不良反应。结论老年精神病患者抗精神病治疗以单一用药为主。     

Acute antipsychotic drug administration lowers body temperature in drug-free male schizophrenic patients

We examined, in a controlled design, potential alterations in body temperature of male schizophrenic patients following acute antipsychotic drug (APD) administration. Fourteen drug-free (study group) and seven schizophrenic patients maintained on APDs (comparison group) initiated or received higher dose of their APD, respectively, for 27 days. Initial body temperature was 0.36°C higher in the study group (P=0.01) and decreased within 24 h to values comparable to that of the comparison group (all within normal range).     

Olanzapine,an atypical antipsychotic,increases rates of punished responding in pigeons

The effects of olanzapine [LY 170053; 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno[2, 3b][1,5]benzodiazepine), a potential atypical antipsychotic, were determined in pigeons whose keypeck responding was punished. These effects were compared to the anxiolytic agents chlordiazepoxide and pentobarbital, and to other antipsychotic agents. Keypeck behavior was maintained under a multiple FR30 FR30 schedule, signalled by white and red stimulus lights, respectively. Each component of the schedule alternated every 3 min with a 30-s timeout. During the white keylight component, responding was maintained by food presentation. During the red keylight component, responding was maintained by food and simultaneously suppressed by electric shock presentation, with response rates being only about 5% of those during the white stimulus light. Olanzapine (0.01–1.0 mg/kg) increased punished responding at doses below those which had an effect on unpunished responding. Clozapine (0.01–1.0 mg/kg), ritanserin (0.1–3.0 mg/kg), and, to a lesser extent, risperidone (0.1–1.0 mg/kg) were also effective at increasing punished responding. Generally, the maximum effect seen with olanzapine was equal to that seen with ritanserin, and it exceeded that seen with clozapine. However, these effects were generally less than those seen with chlordiazepoxide and pentobarbital. Haloperidol (0.01–0.1 mg/kg) was completely without effect on punished responding, while it caused decreases in unpunished behavior. These results provide further evidence that olanzapine has a profile in behavioral tests unlike the typical antipsychotic haloperidol. Moreover, this profile is similar to clozapine, a clinically effective antipsychotic with an atypical profile.     

Dropout rates in randomised antipsychotic drug trials

RATIONALE: It has been assumed that new atypical drugs improve treatment compliance due to fewer adverse effects. Data supporting this assumption are scarce. OBJECTIVES: The aim of this study was to study attrition rates in randomised controlled trials of oral administration of conventional antipsychotic drugs, atypical antipsychotic drugs and placebo. METHODS: The database of the Schizophrenia Module of the Cochrane Library was utilised for the present study. The data in the Cochrane Module are collected by identifying relevant randomised controlled trials from several electronic databases and other sources. Number of dropouts was defined as patients leaving the study preterm due to any reason. RESULTS: Data from 328 treatment groups, consisting of 18,585 randomised subjects from 163 drug trials, were entered in the analysis. One-third of the subjects had dropped out of the trials. The dropout rates significantly increased for each calendar year. Year of trial publication, type of drug and trial length remained statistically significant contributors to dropout rates. In a model incorporating year of publication and trial length, placebo groups and groups treated with conventional antipsychotics had significantly higher attrition rates than groups treated with atypical drugs. When clozapine-treated groups were excluded from the analysis, no statistically significant advantage for atypical drugs over conventional drugs remained. CONCLUSIONS: Trial data implicate that a better compliance can be achieved by favouring atypical drugs rather than conventional alternatives in the treatment of schizophrenia. However, this effect is found only when groups treated with the atypical antipsychotic clozapine are included in the analysis. Our study did not find evidence for a statistically significant superiority in acceptability of novel atypical drugs when compared to conventional antipsychotics.