喹硫平对精神分裂症患者血脂代谢的影响

目的探讨喹硫平对精神分裂症患者血脂代谢的影响,并比较男女之间的差异。方法 2006年1月至2009年1月期间入院予喹硫平治疗的精神分裂症患者346例,分析喹硫平治疗8周前后的空腹血胆固醇(TC)、三酰甘油(TG)浓度变化。结果喹硫平治疗组TC及TG前后变化不明显,差异均无统计学意义(t=1.45),且男女患者之间无明显差异(t=1.03,P>0.05)。结论喹硫平对精神分裂症患者血脂代谢的影响不大,对于高血脂患者用药安全。     

喹硫平与舒必利改善精神分裂症患者认知功能的比较研究

目的：观察喹硫平与舒必利对精神分裂症患者认知功能的改善情况。方法：将50例初诊或经典抗精神病药物治疗疗效不显著或无法耐受不良反应的精神分裂症患者分为喹硫平（n=25）与舒必利（n=25）两组,进行为期3个月的治疗。治疗前后应用PANSS、MMES分别评定精神症状与认知功能。结果：共39例患者完成3个月的治疗（喹硫平=19,舒必利=20）。与基线比较,喹硫平与舒必利都能明显改善精神分裂症患者的精神症状与认知功能,但两组间精神症状与认知功能改善程度并无差异。结论：喹硫平与舒必利都能明显改善精神分裂症患者的认知障碍,疗效无差异。     

阿立哌唑与喹硫平治疗精神分裂症的疗效和安全性

目的 评价阿立哌唑与喹硫平治疗精神分裂症的疗效及安全性.方法 169例符合DSM-Ⅳ(第4版)精神分裂症患者,阿立哌唑组79例,剂量10～30mg·d-1;喹硫平组90例,剂量400～ 750 mg·d-1,疗程均8周.治疗前,治疗第4,8周用阳性和阴性症状量表(PANSS)评价主要疗效.用实验室检查、生命体征、心电图等评价安全性.结果 2组治疗4,8周PANSS总分均较治疗前有显著下降(P均＜0.01),治疗8周末,PANSS总分减分差值及疗效2组间差异无统计学意义.2组药物不良反应发生率分别为25.3％(20/79)和17.7％ (16/90).阿立哌唑组对心率的影响较喹硫平组小;阿立哌唑组甘油三酯水平和心电图QRS间期较治疗前变化明显(P＜0.05).喹硫平组心率、体重、体重指数、血红蛋白、总胆固醇和低密度脂蛋白较治疗前变化明显(P＜0.01).结论 阿立哌唑与喹硫平对精神分裂症疗效相当,两者所致不良反应发生率相近.     

喹硫平与氯氮平对女性精神分裂症患者心电图影响的研究

目的研究喹硫平与氯氮平对女性精神分裂症患者心电图影响的差异。方法 92例女性精神分裂症患者随机分成喹硫平组(50例)及氯氮平对照组(42例),分别使用喹硫平与氯氮平治疗。于治疗后2、4、6周使用ECG-9020机检查心电图。结果喹硫平与氯氮平对女性精神分裂症患者的心电图均有影响,但喹硫平组所致心电图改变发生率明显低于氯氮平组(P<0.01),心电图异常程度轻。结论喹硫平对女性精神分裂症患者心电图的影响程度显著低于氯氮平,安全性较大。     

喹硫平联合舒必利治疗难治性精神分裂症的效果观察

目的分析难治性精神分裂症患者治疗中喹硫平与舒必利联合应用下取得的效果。方法取医院收治的难治性精神分裂症患者,随机分组为对照组和观察组各61例,对照组用药选择氯氮平,观察组给予喹硫平与舒必利联合用药,比较两组患者用药治疗效果与不良反应。结果治疗有效率对比,差异有统计学意义(P <0.05)。两组患者不良反应发生率比较差异有统计学意义(P <0.05)。结论难治性分裂症患者临床治疗中,药物选择喹硫平与舒必利联合用药,可取得显著治疗效果,且用药安全性较高,应在临床实践中推广应用。     

合用阿立哌唑及单用喹硫平对精神分裂症糖脂代谢的影响

目的对比喹硫平与阿立哌唑合用及单用喹硫平对精神分裂症患者空腹血糖、血脂的影响。方法68例精神分裂症患者随机分为阿立哌唑合并喹硫平组（研究组）及单用喹硫平组（对照组）,每组34例。在基线及6周末,用阳性和阴性症状量表（PANSS）评定疗效,并进行空腹血糖（GLU）、三酰甘油（TG）、总胆固醇（TCH）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）的测定。结果共完成63例,研究组31例,对照组32例。治疗6周末．2组PANSS评分差异无统计学意义（t=1．35,P〉0．05）;研究组治疗后GLU、TG升高明显（P〈0．05）,对照组GLU、TG、LDL升高明显（P〈0．05）;组间变化值比较GLU、TG及LDL升高值均较对照组小（P〈0．05）。结论合用阿立哌唑能够明显减轻喹硫平对糖脂代谢的影响。     

喹硫平治疗女性精神分裂症的疗效及对血清催乳素水平的影响

目的?探讨喹硫平治疗女性精神分裂症的疗效及对血清催乳素水平（PRL）的影响。方法?对100例女性精神分裂症患者分别用喹硫平和利培酮治疗8周,以阳性和阴性症状量表(PANSS)评估疗效,以不良反应量表(TESS)评定不良反应,同时检测两组的血清催乳素水平。结果?治疗8周后两组PANSS总分及各因子分均明显下降,与治疗前比较有显著性差异(P<0.001),但两组间各项评分比较,无统计学差异(P>0.05);喹硫平组不良反应较少,其锥体外系不良反应(EPS)的发生率明显低于利培酮组;治疗8周后喹硫平组血清催乳素水平无明显改变,而利培酮组则明显升高,两者比较有统计学差异(P<0.001)。结论?喹硫平治疗女性精神分裂症疗效与利培酮相当,与利培酮比较,喹硫平对女性患者血清催乳素影响较小,锥体外系不良反应更少。     

喹硫平与利培酮对精神分裂症女性患者的临床研究

目的:探讨喹硫平与利培酮对女性精神分裂症进行治疗,对其临床疗效进行观察分析.方法:将我院94例女性精神分裂症患者随机分为两组,分别为利培酮组和喹硫平组,每组47例.喹硫平组口服喹硫平片单一药物进行治疗,利培酮组使用利培酮片单一药物进行口服治疗,对两组治疗后的临床疗效和治疗中的不良反应发生率进行分析.结果:利培酮组治疗总有效率为91.5%,喹硫平组为93.6%,两组治疗效果相当,不具有显著差异(P>0.05);经治疗喹硫平组不良反应发生率低于利培酮组(P<0.05).结论:喹硫平与利培酮治疗女性精神分裂症疗效明显,效果相当,但喹硫平不良反应较少,安全度更高,在临床中具有应用价值.     

喹硫平与舒必利治疗精神分裂症阴性症状分析

目的：探讨喹硫平与舒必利治疗精神分裂症阴性症状的临床特点。方法：回顾2005年1月～2006年1月哈尔滨市第一专科医院治疗的精神分裂症患者50例，随机分为喹硫平治疗组和舒必利治疗对照组，各25例患者．观察临床特点。结果：喹硫平治疗组共计25例患者，其中痊愈5例，显著好转15例，有效3例，无效2例，有效率为92％；舒必利治疗对照组共计25例患者，其中痊愈4例，显著好转16例，有效3例，无效2例，有效率为92％，2组有效率相比，差异无统计学意义，P〉0．05。结论：喹硫平治疗精神分裂症阴性症状有较好疗效，与舒必利相当。但其副作用比舒必利少，是一种比较安全的抗精神病新药。     

精神分裂症患者富马酸喹硫平血浓度测定及血浓度疗效关系

目的建立反相高效液相色谱法测定精神分裂症患者富马酸喹硫平血浓度的方法学,探讨其血浓度与患者年龄、性别、服药剂量及临床疗效的关系.方法采用高效液相色谱法测定76例单一服用富马酸喹硫平的精神分裂症住院患者治疗前及治疗后第2、4、6 wk 肘静脉血浓度,并进行BPRS量表评定及相关性分析.结果富马酸喹硫平血浓度在 0.05～0.5 mg*L-1范围内有良好线性关系(r=0.9850).日剂量50～450 mg 时血浓度随剂量增大而升高,但与服药患者年龄、性别无显著相关性.血浓度在 0.126～0.350 mg*L-1范围内临床效果较好.结论测定方法简便、准确、专一性强,可用于富马酸喹硫平治疗药物监测.治疗窗浓度为 0.126～0.350 mg*L-1.     

Monoamine metabolites and amino acids in serum from schizophrenic patients before and during sulpiride treatment

Twenty-four acutely ill schizophrenic patients (DSM-III-R), 18–42 years old, were treated for 6 weeks with sulpiride. Sulpiride was administered in three different daily dosages (starting with 400, 800 or 1200 mg) according to a double blind randomized administration schedule. The monoamine metabolites (MAM) homovanillic acid (HVA), 5-hydroxy-indoleacetic acid (5-HIAA), 4-hydroxy-3-methoxy-phenylglycol (HMPG) and the amino acids tyrosine, tryptophan, glutamate and glutamine were measured in serum before treatment and once a week during treatment. There were no significant differences between healthy controls and schizophrenic patients in serum levels of monoamine metabolites and amino acids before treatment. There was no dose-response effect of sulpiride on serum levels of the monoamine metabolites or the amino acids. The results are therefore based on the whole group of patients. During treatment the HMPG levels were reduced at all points in time. The serum level of HVA was significantly reduced after 6 weeks. The 5-HIAA and the amino acid levels were not changed during treatment. There were no significant correlations among the monoamine metabolites before treatment. During treatment, however, significant correlations were found among MAM and amino acids. Since the biochemical findings during the treatment were not related to the dose or the concentration of sulpiride the results may be related to secondary biochemical effects of sulpiride and/or to changes in the clinical state following treatment.     

In vivo bioequivalence study of Sulpirid (GYKI-Alkaloida) and Dogmatil fort (Delagrange) 200 mg sulpiride tablets in healthy volunteers]

A single-dose, "crossover" bioequivalence study was conducted in healthy volunteers by comparing sulpiride serum levels after oral administration of the Test Product Sulpiride (200 mg) (GYKI-Alkaloida) in fasting subjects with those produced after oral administration of a marketed reference product (200 mg) (Delagrange Co., France). Statistical comparisons of Cmax, Tmax and AUC0-infinity have been performed utilizing ANOVA with subject, group, subject within group, period and product as sources of variance. No significant differences between the Test Drug and the Reference Drug considering the pharmacokinetic parameters Cmax, Tmax and AUC0-infinity were found. The 95% confidence intervals were as follows: AUC0-infinity: -20.46% and 31.19%, Cmax: -28.05% and 26.65% and Tmax: -43.53% and 20.67%. In the study for the analysis of Sulpiride a specific HPLC procedure with uv detection (lambda = 228 nm) and an internal standard were applied according to P. Nicolas et al. with modification. Sulpiride levels in serum reached a maximum at 4.4 hr +/- 1.5 (S.D.) following administration of Sulpiride tablet and at 5.0 hr +/- 0.8 (S.D.) after Dogmatil fort tablet. The maximal serum concentrations were 506.1 ng/ml +/- 87.2 (S.D.) and 509.1 ng/ml +/- 101.9 (S.D.) for Sulpiride and Dogmatil fort, respectively. The half-life of Sulpiride in serum was 9.9 hr +/- 1.3 (S.D.) following dosing with Dogmatil fort tablet and 12.2 hr +/- 3.0 (S.D.) following dosing with Sulpiride tablet.     

Relationships between clinical effects and monoamine metabolites and amino acids in sulpiride-treated schizophrenic patients

Twenty-four acutely ill schizophrenic patients (DSM-III-R), 18–42 years old, were treated for 6 weeks with sulpiride. Sulpiride was administered in three different daily dosages (400, 800 or 1200 mg) according to a double dummy blind randomized administration schedule. The psychopathology of the patients was rated by the Comprehensive Psychopathological Rating Scale (CPRS) and the Nurse's Observation Scale for Inpatient Evaluation (NOSIE). The monoamine metabolites homovanillic acid (HVA), 5-hydroxy-indoleacetic acid (5-HIAA), 4-hydroxy-3-methoxy-phenylglycol (HMPG) and the amino acids tyrosine, tryptophan, glutamate and glutamine were measured in serum before and once a week during sulpiride treatment. There were no significant correlations between the CPRS or the NOSIE morbidity scores and the biochemical measures before drug treatment. HVA levels were not correlated to rating scores during treatment, but after 6 weeks HVA had decreased significantly in the patients with a good response but not in the patients with a poor response. A negative relationship between 5-HIAA levels and depressive and negative symptoms was found. Nonresponders according to the subscale for depression had low 5-HIAA levels throughout the treatment. An increase of tryptophan was correlated to improvement in the early part of treatment. High levels of glutamate or glutamine were found in non-responders before treatment. During treatment an increase of the glutamate level was correlated to improvement. Low levels of glutamine were related to improvement according to global and NOSIE (total) rating scores. Peripheral biochemical measures may be a valuable tool in the study of pathophysiological mechanisms and treatment effects in patients with schizophrenia.     

Effects of sulpiride and ethylene glycol monomethyl ether on endometrial carcinogenicity in Donryu rats

Sulpiride and ethylene glycol monomethyl ether (EGME) are known ovarian toxicants that stimulate prolactin (PRL) secretion, resulting in hypertrophy of the corpora lutea and increased progesterone (P4) production. The purpose of the present study was to investigate how the PRL stimulatory agents affected uterine carcinogenesis and to clarify the effects of PRL on endometrial adenocarcinoma progression in rats. Ten‐week‐old female Donryu rats were treated once with N‐ethyl‐N′‐nitro‐N‐nitrosoguanidine (20 mg kg^?1), followed by treatment with sulpiride (200 ppm) or EGME (1250 ppm) from 11 weeks of age to 12 months of age. Sulpiride treatment inhibited the incidence of uterine adenocarcinoma and precancerous lesions of atypical endometrial hyperplasia, whereas EGME had no effect on uterine carcinogenesis. Sulpiride markedly prevented the onset of persistent estrus throughout the study period, and EGME delayed and inhibited the onset of persistent estrus. Moreover, sulpiride‐treated animals showed high PRL and P4 serum levels without changes in the levels of estradiol‐17β, low uterine weights and histological luteal cell hypertrophy. EGME did not affect serum PRL and P4 levels. These results suggest that the prolonged low estradiol‐17β to P4 ratio accompanied by persistent estrous cycle abnormalities secondary to the luteal stimulatory effects of PRL may explain the inhibitory effects of sulpiride on uterine carcinogenesis in rats. Copyright © 2015 John Wiley & Sons, Ltd.     

Quetiapine versus placebo in combination with lithium or divalproex for the treatment of bipolar mania

Quetiapine (QTP) combined with lithium (Li) or divalproex (DVP) for the treatment of mania was evaluated in 2 double-blind, placebo-controlled studies. Patients were randomized to 3 or 6 weeks of treatment with QTP plus Li/DVP or placebo (PBO) plus Li/DVP. Quetiapine was dosed up to 800 mg/d; Li was dosed to achieve serum concentrations of 0.7-1.0 mEq/L and DVP to 50-100 microg/mL. A total of 402 patients were randomized: 197 to QTP + Li/DVP and 205 to PBO + Li/DVP. The mean quetiapine dose in responders was 492 (+/-204) mg/d. Improvement in the Young Mania Rating Scale (YMRS) at day 21 in the QTP + Li/DVP group (-15.29) was statistically superior to the PBO + Li/DVP group (-12.19) (P < 0.05). A statistically significant difference in favor of quetiapine was observed within the first week (P < 0.05). Significantly more QTP + Li/DVP patients achieved a response (> or =50% decrease in the YMRS) at day 21 (QTP + Li/DVP, 55.7%; PBO + Li/DVP, 41.6%;P < 0.01). Improvements in Clinical Global Impression-Bipolar Severity of Illness scores by day 21 were also significantly greater in QTP + Li/DVP-treated patients (-1.59) versus PBO + Li/DVP (-1.19) (P < 0.01). Common adverse events (> or =5% and twice that in the PBO + Li/DVP group) in the QTP + Li/DVP group were somnolence, dry mouth, and asthenia. Quetiapine combined with Li/DVP was not associated with extrapyramidal symptoms (including akathisia) or emergent depression. More QTP + Li/DVP-treated patients completed the trial, and there was no difference in discontinuation rates due to adverse events between the two groups. Quetiapine, in combination with lithium or divalproex, is well tolerated and has superior efficacy to lithium or divalproex alone in the treatment of bipolar mania.     

喹硫平联合氯硝西泮治疗老年躁狂症的临床研究及对血清NE、5-HT、DA水平的影响

目的探讨喹硫平联合氯硝西泮治疗老年躁狂症的临床疗效及其对血清去甲肾上腺素(NE)、五羟色胺(5-HT)、多巴胺(DA)水平的影响。方法选取2018年1月—2019年4月石家庄市第八医院老年躁狂症患者117例作为研究对象,根据治疗方案不同将患者分为对照1组、对照2组、观察组,每组各39例。对照1组口服富马酸喹硫平片,起始剂量为25 mg/次,2次/d,每隔1~3 d增加25 mg,最大剂量300~600 mg/d,分2~3次服用。对照2组口服氯硝西泮片,1 mg/d。观察组采用富马酸喹硫平片联合氯硝西泮片治疗,用法用量同对照1组、对照2组。3组均持续治疗8周。观察3组患者的临床疗效,同时比较3组的贝克-拉范森躁狂量表(BRMS)评分、阳性与阴性症状量表(PANSS)评分、及NE、5-HT、DA、白细胞介素(IL)-2、IL-1β、肿瘤坏死因子(TNF)-α的水平。结果治疗后,观察组总有效率为94.87%,显著高于对照1组的76.92%和对照2组的74.36%(P<0.05)。治疗2、4、6、8周后,3组BRMS评分和PANSS评分均显著降低(P<0.05);且观察组BRMS评分和PANSS评分显著低于同期对照1组、对照2组(P<0.05)。治疗8周后,3组血清5-HT、NE、DA、IL-2、IL-1β和TNF-α水平均显著降低(P<0.05);且观察组血清5-HT、NE、DA、IL-2、IL-1β和TNF-α水平较同期对照1组、对照2组显著降低(P<0.05)。结论喹硫平联合氯硝西泮治疗老年躁狂症患者的疗效显著,在提高神经递质因子水平、抑制炎性反应方面具有显著优势,可进一步缓解患者躁狂程度,减轻临床症状,且具有一定安全性,值得临床推广。     

我院2007年11月～2008年11月精神分裂症住院患者用药情况分析

目的:评价我院住院精神分裂症患者的用药情况。方法:采用世界卫生组织推荐的限定日剂量和药物利用指数(DUI)法,对我院2007年11月～2008年11月精神分裂症住院患者的用药情况进行统计、分析。结果:用药频度(DDDs)排序列前3位是喹硫平、奥氮平、利培酮,均为非典型抗精神病药,典型抗精神病药舒必利列第17位;大部分药物的DUI<1.0。结论:我院多数精神分裂症患者用药合理,非典型抗精神病药在临床占主导地位。     

鲁拉西酮联合舒必利治疗精神分裂症的临床研究

目的 探讨盐酸鲁拉西酮片联合舒必利片治疗精神分裂症的临床疗效。方法 选取2020年2月-2022年11月在上海市静安区精神卫生中心就诊的120例精神分裂症患者,按照计算机随机排列法分为对照组和治疗组,每组各60例。对照组患者口服舒必利片,首次剂量1片/次,3次/d,治疗7 d后增加至3片/次,3次/d。治疗组患者在对照组基础上口服盐酸鲁拉西酮片,1片/次,1次/d。两组患者连续治疗2个月。观察两组的临床疗效,比较两组的阳性与阴性症状量表(PANSS)评分、精神分裂症生活质量量表(SQLS)评分以及血清中催乳素(PRL)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)水平。结果 治疗后,治疗组的总有效率为91.67%,对照组的总有效率为78.33%,组间比较差异有统计学意义(P<0.05)。治疗后,两组的PANSS各项评分均显著降低(P<0.05),且治疗组PANSS各项评分较对照组更低(P<0.05)。治疗后,两组的SQLS各项评分显著降低(P<0.05),治疗组SQLS各项评分降低程度高于对照组(P<0.05)。治疗后,两组的血清PRL水平高于治疗前,血清IL-6、IL-17水平低于治疗前(P<0.05);治疗后,治疗组的血清IL-6、IL-17水平低于对照组(P<0.05)。结论 盐酸鲁拉西酮片联合舒必利片可提高精神分裂症的临床疗效,减轻患者精神症状,提高生活质量,减轻炎症反应,且药物安全性良好。     

Quetiapine. A review of its use in the management of schizophrenia

Quetiapine (Seroquel), a dibenzothiazepine derivative, is an atypical antipsychotic with demonstrated efficacy in acute schizophrenia. In short-term, randomised, double-blind trials, it was usually more effective than placebo, and was generally effective against both positive and negative symptoms. Overall, quetiapine (up to 750 mg/day) was at least as effective as chlorpromazine (up to 750 mg/day) and had similar efficacy to haloperidol (up to 16 mg/day) in patients with acute schizophrenia in randomised, double-blind trials; it was at least as effective as haloperidol 20 mg/day in patients with schizophrenia unresponsive or partially responsive to previous antipsychotic treatment. Improvements in overall psychopathology and positive and negative symptoms with quetiapine (up to 800 mg/day) were similar to those with risperidone (up to 8 mg/day) or olanzapine (15 mg/day) [interim analysis]. Efficacy was maintained for at least 52 weeks in open-label follow-up studies in adult and elderly patients. Quetiapine improved cognitive function versus haloperidol, and depressive symptoms and hostility/aggression versus placebo. Quetiapine is well tolerated. It is associated with placebo-level incidence of extrapyramidal symptoms (EPS) across its entire dose range, appears to have a low risk for EPS in vulnerable patient groups (e.g. the elderly, adolescents or patients with organic brain disorders) and has a more favourable EPS profile than risperidone. Irrespective of dose, quetiapine, unlike risperidone and amisulpride, does not elevate plasma prolactin levels compared with placebo, and previously elevated levels may even normalise. Quetiapine appears to have minimal short-term effects on bodyweight and a favourable long-term bodyweight profile. Preliminary studies indicate that there is a high level of patient acceptability and satisfaction with quetiapine. In conclusion, quetiapine has shown efficacy against both positive and negative symptoms of schizophrenia, and has benefits in improving cognitive deficits, affective symptoms and aggression/hostility. The beneficial effects of quetiapine have been maintained for at least 52 weeks. Quetiapine was effective and well tolerated in hard-to-treat patients, and may be of particular use in these individuals. It is at least as effective as standard antipsychotics and appears to have similar efficacy to risperidone and olanzapine. The relative risk/benefit profile of quetiapine compared with other atypical antipsychotics requires further research in head-to-head trials, although quetiapine's relatively benign tolerability profile distinguishes it from other commonly used atypical agents, particularly with respect to bodyweight, EPS and plasma prolactin levels. Overall, quetiapine has an excellent risk/benefit profile and is a suitable first-line option for the treatment of schizophrenia.     

Quetiapine: a review of its use in acute mania and depression associated with bipolar disorder

Quetiapine (Seroquel), an atypical antipsychotic with established efficacy in the treatment of schizophrenia, shows efficacy in the treatment of acute mania and depression associated with bipolar disorder.Quetiapine, either as monotherapy or in combination with lithium or divalproex sodium (valproate semisodium), is generally well tolerated and effective in reducing manic symptoms in adult and adolescent patients with acute bipolar mania, and is approved for use in adults for this indication. As monotherapy, the drug is also effective in reducing depressive symptoms in patients with bipolar depression. It is associated with a low incidence of extrapyramidal symptom (EPS)-related adverse events and low EPS ratings in bipolar disorder. Quetiapine thus shows potential in the treatment of bipolar depression, and represents a useful agent for the treatment of acute bipolar mania.