齐拉西酮合并阿米替林治疗难治性抑郁症的临床研究

目的观察齐拉西酮合并阿米替林治疗难治性抑郁症的疗效和毒副作用。方法根据入院顺序分层随机法,将60例难治性抑郁症患者平均分为研究组（齐拉西酮＋阿米替林）和对照组（阿米特林＋安慰剂）,在治疗前、治疗后4、8、12周末分别用汉密尔顿抑郁量表（HAMD）、总体疗效量表（CGI）和副反应量表（TESS）评定疗效和毒副作用。结果治疗4周后研究组HAMD总分及各因子分比治疗前明显降低,且治疗因子分显著低于对照组,治疗后4、8、12周末TESS评分,4周末研究组高于对照组,8、12周末两组无显著差异。结论齐拉西酮合并阿米替林治疗难治性抑郁症疗效确切。     

齐拉西酮对精神分裂症患者生活质量的影响

目的比较齐拉西酮与氟哌啶醇对精神分裂症患者生活质量的影响。方法对门诊74例服用氟哌啶醇及72例服用齐拉西酮的精神分裂症患者用生活质量综合评定问卷(GQOLI),阳性症状及阴性症状量表(PANSS),副反应量表(TESS)进行调查、分析。结果齐拉西酮组患者的生活质量优于氟哌啶醇组。结论齐拉西酮治疗精神分裂症更有利于患者提高生活质量和适应社会。     

齐拉西酮治疗难治性精神分裂症的疗效分析

目的探讨齐拉西酮治疗难治性精神分裂症患者的疗效和安全性。方法对60例难治性精神分裂症患者换用齐拉西酮进行治疗,疗程16周。在治疗前、治疗后2、4、8、12、16周用阳性症状与阴性症状量表(PANSS)、不良反应症状量表(TESS)评价其疗效和副反应。结果经齐拉西酮治疗后PANSS总分与治疗前比较有显著性差异(P<0.01),阳性、阴性和一般精神病理症状量表评分比治疗前减低(P<0.05)。结论齐拉西酮对难治性精神分裂症疗效肯定,安全性高。     

Ziprasidone in the Treatment of Affective Disorders: A Review

Ziprasidone was the fifth atypical antipsychotic approved by Food and Drug Administration (FDA) for use in bipolar mania and mixed episodes. This atypical antipsychotic has a unique profile, as it acts primarily through serotonergic and dopaminergic receptor antagonism, but also exerts effects as an inhibitor of norepinephrine reuptake. Moreover, one of the advantages of ziprasidone is its safety profile as it is not associated with clinically significant metabolic side effects and little or no effect on prolactin level or anticholinergic side effects. Most of the studies evaluating ziprasidone's efficacy and safety are short‐term double‐blind, placebo‐controlled studies in acute mania and mixed episodes. In two of them, ziprasidone was associated to significant improvement in the primary measures assessed. However, an add‐on study, lithium plus ziprasidone showed similar results than lithium monotherapy, although there was a significant advantage for the combination within the first week. In a more recent trial, ziprasidone was compared with placebo and haloperidol as monotherapies, again beating placebo. In that trial, ziprasidone appeared to be safer and better tolerated, although less likely efficacious than haloperidol. Particularly, subjects treated with ziprasidone were less likely to switch to depression. Despite the well‐studied efficacy of ziprasidone in the first weeks of treatment, there are no controlled trials that evaluate the role and efficacy of ziprasidone in long‐term treatment of bipolar disorder (BD). Overall, in the open‐label extension studies, there was a global improvement at all visits compared with baseline scores. Furthermore, ziprasidone appears to offer some antidepressant effect in patients with major depressive episode and resistant to treatment, as demonstrated in add‐on open‐label studies with ziprasidone plus selective serotonin reuptake inhibitor (SSRI).     

齐拉西酮对精神分裂症患者睡眠的影响

目的采用多导睡眠图（Polysomnogram,PSG）指标观察新型抗精神病药物齐拉西酮对精神分裂症患者客观睡眠情况的影响.方法：将符合诊断标准的45 例住院的精神分裂症患者列为病例组,按常规给予齐拉西酮治疗,并于治疗前和治疗后4 周进行多导睡眠图描记;45 名健康志愿者为对照组.结果：与对照组相比,病例组患者治疗前总睡眠时间减少,睡眠潜伏期延长,睡眠效率下降,觉醒时间、S1 睡眠时间增多,REM 睡眠潜伏期缩短,REM 睡眠时间、SWS 睡眠时间减少,差异有显著的统计学意义（P〈0. 01）.S2 睡眠比较的结果无统计学差异（P〉0. 05）.服药4 周后病例组患者较基线总睡眠时间延长,觉醒时间、S1 睡眠时间减少,睡眠效率提高,S2 、SWS 睡眠时间增多,差异有显著的统计学意义（P〈0. 01）.结论：精神分裂症患者存在睡眠结构和睡眠连续性两方面的异常,齐拉西酮能改善精神分裂者患者的客观睡眠情况.     

Ziprasidone 40 and 120 mg/day in the acute exacerbation of schizophrenia and schizoaffective disorder: a 4-week placebo-controlled trial

A double-blind, placebo-controlled, multicenter study, was performed to evaluate the efficacy and safety of ziprasidone in 139 patients with an acute exacerbation of schizophrenia or schizoaffective disorder. Patients were randomized to receive ziprasidone 40 mg/day, 120 mg/day or placebo for 28 days. Ziprasidone 120 mg/day was significantly more effective than placebo in improving the BPRS total, CGI-S, BPRS depression cluster and BPRS anergia cluster scores (all P < 0.05). Similarly, the percentages of patients classified as responders on the BPRS (≥30% reduction) and the CGI improvement (score ≤2) were significantly greater with ziprasidone 120 mg/day compared with placebo (P < 0.05). The number of patients who experienced an adverse event was similar in all three treatment groups, and discontinuation due to adverse events was rare (five of 91 ziprasidone-treated patients). The most frequently reported adverse events, that were more common in either ziprasidone group than in the placebo group, were dyspepsia, constipation, nausea and abdominal pain. There was a notably low incidence extrapyramidal side-effects (including akathisia) and postural hypotension and no pattern of laboratory abnormalities or apparent weight gain. Ziprasidone-treated patients were not clinically different from placebo-treated patients on the Simpson-Angus Rating scale, Barnes Akathisia scale and AIMS assessments. These results indicate that ziprasidone 120 mg/day is effective in the treatment of the positive, negative and affective symptoms of schizophrenia and schizoaffective disorder with a very low side-effect burden. Received: 5 November 1997/Final version: 16 March 1998     

齐拉西酮对女性精神分裂症疗效的随访研究

目的探讨齐拉西酮对女性精神分裂症患者的远期疗效。方法将100例女性精神分裂症患者随机分为两组,分别予齐拉西酮和利培酮治疗,疗程8周,治疗结束后作1年的随访研究。用简明精神病评定量表(BPRS)、副反应量表(TESS)和生活质量综合评定问卷(GQOLI-74)进行相关评定。结果治疗前两组间各项评分均无统计学差异;治疗后两组BPRS、GQOLI-74总分及治疗依从性与治疗前相比均显著提高(P<0.05～0.01);两组有效率分别为94%和92%,无统计学差异(P>0.05);8周内两组间各时点BPRS总分无统计学差异。出院1年后,研究组的BPRS总分及社会功能分均优于对照组;复发率、再住院率均低于对照组。结论齐拉西酮是一种安全有效的非典型抗精神病药,能较好地控制精神症状;不良反应小,治疗依从性好,尤其适合女性精神分裂症患者的长期康复。     

齐拉西酮与利培酮对首发精神分裂症患者生活质量影响的对照研究

目的比较齐拉西酮与利培酮对首发精神分裂症患者生活质量的影响。方法将符合条件的71例首发精神分裂症患者随机给予齐拉西酮和利培酮治疗,用阳性与阴性症状量表(PANSS)评定疗效,副反应量表和相关实验室检查评定副反应,精神分裂症病人生活质量量表评定患者的生活质量。结果治疗后两组患者在PANSS量表减分率相当(χ2=0.40,P>0.05),副反应发生率上无显著差异(χ2=0.40,P>0.05),而齐拉西酮组在改善病人生活质量方面的效果明显高于利培酮组(P<0.01)。结论齐拉西酮在提高精神分裂症患者生活质量方面的效果明显优于利培酮。     

齐拉西酮和喹硫平对女性精神分裂症患者代谢综合征患病率的影响

目的探讨和分析齐拉西酮与喹硫平对女性精神分裂症患者代谢综合征患病率的影响。方法将符合入组标准的68例女性精神分裂症患者随机分为两组,每组各34例。分别于治疗前、治疗后1个月和3个月测定体重指数(BMI)、腰围、血压、空腹血糖(FBS)、甘油三酯(TG)和高密度脂蛋白(HDL-C),并进行比较分析。结果齐拉西酮组和喹硫平组代谢综合征的发病率分别为5.88%和21.05%。结论齐拉西酮治疗女性精神分裂症患者,发生代谢综合征的风险低于喹硫平。     

齐拉西酮治疗甲基苯丙胺所致精神障碍临床疗效观察

目的观察抗精神病药物齐拉西酮治疗甲基苯丙胺所致精神障碍的疗效及不良反应。方法 80例甲基苯丙胺所致精神障碍患者按随机数字表法分为齐拉西酮组和利培酮组各40例,分别用齐拉西酮（最大剂量≤160 mg/d）和利培酮（最大剂量≤6 mg/d）治疗21天。采用简明精神病量表（BPRS）和副反应量表（TESS）评定患者的精神病性症状、疗效和不良反应。结果总有效率齐拉西酮组为92.50%,利培酮组为90.00%,两组比较差异无统计学意义（P〉0.05）;齐拉西酮组与利培酮组比较,体重增加较少,内分泌改变较少,差异有统计学意义（P〈0.05）;其他不良反应,两组差异无统计学意义（P〉0.05）。结论齐拉西酮与利培酮疗效相当,不良反应较轻。