阿立哌唑口崩片与利培酮治疗精神分裂症对照研究

目的：探讨阿立哌唑口崩片与利培酮治疗精神分裂症患者的临床疗效和安全性。方法将60例精神分裂症患者随机分为两组,每组30例,研究组口服阿立哌唑口崩片治疗,对照组口服利培酮片治疗,观察12周。治疗前后采用阳性与阴性症状量表评定临床疗效,副反应量表评定不良反应。结果治疗后两组阳性与阴性症状量表总分及各因子分均较治疗前显著下降（P＜0.01）,治疗各时点两组评分比较差异均无显著性（P＞0.05）,治疗12周末研究组有效率86.7％,对照组为83.3％,两组比较差异无显著性（ P＞0.05）。两组不良反应均轻微,研究组治疗第12周末副反应量表评分显著低于对照组（ P＜0.05）。结论阿立哌唑口崩片与利培酮治疗精神分裂症疗效显著且相当,但阿立哌唑口崩片安全性更高,依从性更好。     

阿立哌唑与利培酮治疗脑血管疾病所致精神障碍对照观察

目的：探讨阿立哌唑与利培酮治疗脑血管疾病所致精神障碍的临床疗效及安全性。方法将20例脑血管疾病所致精神障碍患者随机分为两组,分别予以阿立哌唑和利培酮治疗,观察6周。于治疗前后采用阳性与阴性症状量表评定临床疗效,副反应量表评定不良反应。结果治疗后两组阳性与阴性症状量表评分较治疗前显著降低（P＜0．01）,同期两组间比较差异无显著性（P＞0．05）;阿立哌唑组不良发应发生率低于利培酮组,但差异无显著性（P＞0．05）。结论阿立哌唑治疗脑血管疾病所致精神障碍疗效显著,与利培酮相当,但安全性更高。     

解郁安神汤合并阿立哌唑治疗慢性精神分裂症临床观察

目的探讨解郁安神汤合并阿立哌唑治疗慢性精神分裂症的疗效和安全性。方法将100例慢性精神分裂症患者随机分为研究组（解郁安神汤合并阿立哌唑治疗）和对照组（单用阿立哌唑治疗）各50例,观察时间12周,用阳性和阴性综合征量表（PANSS）和副反应量表（TESS）评定疗效和安全性。结果治疗12周后,研究组愈显率显著高于对照组,PANSS评分较治疗前显著下降且低于同期对照组,减分速度和幅度也大于后者,但TESS评分同期比较差异无显著性。结论解郁安神汤合并阿立哌唑治疗慢性精神分裂症疗效确切,起效较快,优于单用阿立哌唑治疗,且不增加不良反应,安全性好。     

利培酮合并小剂量阿立哌唑治疗女性精神分裂症对照研究

目的：探讨利培酮联合小剂量阿立哌唑治疗女性精神分裂症的疗效及对泌乳素的影响。方法：70例女性精神分裂症患者随机分为利培酮联合小剂量阿立哌唑治疗组和利培酮治疗组。治疗前及治疗后第2、4、8周末采用PANSS评定临床疗效。采用TESS评定药物不良反应。结果：利培酮联合小剂量阿立哌唑治疗组有效率为85.7%,利培酮组治疗有效率为88.6%,无显著性差异;两组不良反应（包括高泌乳素血症相关的泌乳、闭经）差异无统计学意义。结论：利培酮联合小剂量阿立哌唑治疗女性精神分裂症疗效及耐受性均好,未出现高泌乳血症相关症状,利培酮治疗女性精神分裂症时不必要预防应用阿立哌唑。     

奎硫平和阿立哌唑对精神分裂症患者睡眠质量的影响

目的：了解急性期精神分裂症患者主观睡眠质量及奎硫平、阿立哌唑对患者主观睡眠质量的影响。方法：将符合国际疾病分类第10版精神分裂症诊断标准的患者68例,按入院的先后顺序分为奎硫平组34例和阿立哌唑组34例,用匹兹堡睡眠质量指数（PSQI）和睡眠状况自评量表（SRSS）进行主观睡眠评价,用阳性和阴性症状量表（PANSS）、简明精神病评定量表（BPRS）评定精神症状。用治疗中出现的症状量表（TESS）评定不良反应。结果：共57例完成研究。奎硫平组治疗前PSQI总分平均（11．81±4．81）分、治疗后（1．14±1．75）分;SRSS总分治疗前（32．16±7．13）分、治疗后（16．10±4．67）分。阿立哌唑组治疗前PSQI总分平均（10．97±5．28）分、治疗后（3．60±3．71）分;SRSS总分治疗前平均（29．73±7．31）分、治疗后（20．33±10．53）分。多元逐步回归分析显示,入组时PSQI总分、SRSS总分与PANSS分呈正相关（r=0．496,P=0．000;r=0．391,P=0．000）。结论：急性期精神分裂症患者主观睡眠质量降低,入睡时间延长,实际睡眠时间减少。经奎硫平或阿立哌唑治疗后,睡眠质量改善。     

Unusual weight fluctuation under corticosteroid and psychotropic treatment

It is generally accepted that corticosteroid therapy may increase weight. Because corticosteroids may induce several psychiatric symptoms, psychotropic drugs are required to treat these symptoms in some cases. The present study describes a patient who had unusual weight fluctuation under corticosteroid and psychotropic treatment such as mianserin and aripiprazole.     

阿立哌唑治疗精神分裂症的疗效与安全性分析

目的比较阿立哌唑与利培酮治疗精神分裂症的疗效及安全性。方法将82例精神分裂症患者随机均分为两组,分别使用阿立哌唑和利培酮治疗,疗程8周,采用阳性与阴性症状量表（PANSS）评定疗效,采用副反应量表（TESS）评定不良反应。结果两组间疗效比较差异无显著性（P〉0．05）,阿立哌唑组不良反应较利培酮组少,但无明显差异（P〉0．05）。结论阿立哌唑是一种安全有效、耐受性好的抗精神病药,值得临床推广。     

A case series: evaluation of the metabolic safety of aripiprazole

Metabolic abnormalities occur frequently in patients treated with antipsychotics and are of growing concern to clinicians. This study sought to determine whether antipsychotic-associated metabolic abnormalities identified through intensive monitoring can be reversed by switching to aripiprazole. Recent evidence suggests that aripiprazole may exhibit a favorable metabolic safety profile. The study population is a subset of a large (n > 500) ongoing prospective cohort. Thirty-one consecutive patients with schizophrenia who were started on aripiprazole were included in the study. All patients underwent an extensive metabolic evaluation, including an oral glucose tolerance test, at baseline, at 6 weeks, and at 3 months post switch. Metabolic abnormalities were defined as any of the following: new onset diabetes, impaired fasting glucose, impaired glucose tolerance, metabolic syndrome (MetS) according to various definitions, and dyslipidemia. After 3 months of treatment with aripiprazole (mean daily dose 16.3 mg), there was a significant decrease in body weight, body mass index, and waist circumference. There was a significant reduction in fasting glucose, fasting insulin, insulin resistance index, and serum lipids levels (cholesterol, triglycerides, low-density lipoprotein (LDL), LDL/HDL, Chol/HDL, and non-HDL cholesterol). There was also a significant reduction in prolactin levels. All 7 cases of recent onset diabetes were reversed at 3 months follow-up. The MetS was reversed in 50% of patients at 3 months follow-up. Our results support the reversibility of recent onset diabetes on antipsychotic medication when detected early and followed by a switch to aripiprazole.     

Aripiprazole in combination with other antipsychotic drugs may worsen psychosis

Aripiprazole is a new generation antipsychotic drug with a partial agonist effect on dopamine D2 and D3 receptors. We report the case of a schizophrenic patient whose symptoms worsened after adding aripiprazole to another antipsychotic drug (amisulpiride). The physiopathology of this process seems to be mediated through the dopaminergic effect of aripiprazole in hypodopaminergic environments, caused by the administration of antipsychotic drugs such as amisulpiride. Besides this, the chronic administration of neuroleptic drugs may induce a hypersensitivity to dopamine agonists. In this context, we consider that the dopaminergic effect of aripiprazole may have induced a worsening of psychotic symptoms. We conclude that clinicians should be cautious when adding aripiprazole to patients under treatment with dopamine antagonists with a high affinity for D2 and D3 receptors.