阿立哌唑与洛沙平治疗首发精神分裂症对照研究

目的 探讨阿立哌唑与洛沙平治疗首发精神分裂症患者的临床疗效和安全性.方法 将120例首发精神分裂症患者随机分为两组,每组60例,研究组口服阿立哌唑治疗,对照组口服洛沙平治疗,观察6周.于治疗前及治疗第2周、4周、6周末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有显著下降(P＜0.01),同期两组间比较差异均无显著性(P＞0.05);治疗6周末,研究组显效率70.0%、有效率90.0%,对照组分别为76.7%、91.7%,两组疗效差异无显著性(P＞0.05).两组不良反应均较轻微,研究组恶心呕吐、头晕头痛、嗜睡不良反应发生率均显著高于对照组(P＜0.05或0.01);锥体外系反应、肌强直、体质量增加、内分泌改变、月经改变和泌乳、性欲改变不良反应发生率均显著低于对照组(P＜0.01).结论 阿立哌唑治疗首发精神分裂症疗效显著且与洛沙平相当,不良反应轻微,安全性高,依从性好,可作为治疗精神分裂的一线药物在临床推广应用.     

阿立哌唑与奥氮平治疗首发精神分裂症对照研究

目的 探讨阿立哌唑治疗首发精神分裂症的临床疗效和安全性.方法 将60例首发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治疗,对照组口服奥氮平治疗,观察8周.于治疗前及治疗2周、4周、6周、8周末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有显著下降(P＜0.01),治疗8周末,研究组显效率66.7%、有效率83.3%,对照组分别为70.0%、86.7%,两组比较差异无显著性(χ2=0.08、0.13,P＞0.05).研究组不良反应发生率为33.3%,对照组为63.3%,研究组显著低于对照组(χ2=5.41,P＜0.05).结论 阿立哌唑能有效改善首发精神分裂症患者的各种精神症状,疗效显著且与奥氮平相当,不良反应轻微,对体质量几乎无影响,安全性高,依从性好.     

经颅磁刺激与阿立哌唑治疗利培酮所致高催乳素血症对照研究

目的 探讨低频重复经颅磁刺激与小剂量阿立哌唑治疗利培酮所致高催乳素血症的临床疗效和安全性.方法 将100例利培酮所致高催乳素血症的精神分裂症患者随机分为两组,每组50例,两组均维持原用利培酮治疗剂量不变,在此基础上研究组联合低频重复经颅磁刺激治疗,对照组联合小剂量阿立哌唑治疗.观察4周.于治疗前后采用阳性与阴性症状量表评定两组临床症状,同时检测血清催乳素水平,对检测结果进行对比分析.记录两组不良反应.结果 治疗后两组血清催乳素水平均较治疗前有显著下降(P＜0.01);同期两组间比较差异均无显著性(P＞0.05).研究组不良反应主要表现为轻、中度头痛,对照组主要表现为锥体外系反应,两组不良反应均较轻微,发生率差异无显著性(P＞0.05).结论 低频重复经颅磁刺激与小剂量阿立哌唑均能显著降低利培酮引起精神分裂症患者的高催乳素水平,且疗效相当,安全性高.     

阿立哌唑对首发男性精神分裂症认知功能的影响

目的比较阿立哌唑和奋乃静对首发精神分裂症认知功能的影响。方法将符合入组标准的首发男性精神分裂症患者60例随机分为阿立哌唑组与奋乃静组,分别进行6周的系统治疗,采用简明精神病评定量表(BPRS)、简易智能状态检查量表(MMSE)进行测评其疗效和对认知功能的影响。结果 60例患者在6周治疗后BPRS总分明显下降(P<0.01),但2组之间的差异无统计学意义(P>0.05)。阿立哌唑组的MMSE总分明显高于奋乃静组,差异有统计学意义(P<0.05)。结论阿立哌唑组对首发男性精神分裂症认知功能的影响明显好于奋乃静组。     

舍曲林联合阿立哌唑治疗强迫症的临床观察

目的 探讨舍曲林联合阿立哌唑治疗强迫症的临床疗效及耐受性.方法 86例强迫症患者随机分为观察组(n=43)和对照组(n=43),观察组用舍曲林和阿立哌唑联合治疗,对照组单用舍曲林治疗,观察治疗12周.于治疗前、治疗4周末、8周末、12周末分别用耶鲁布朗强迫量表(Y-BOCS)评定强迫症状、用汉密尔顿焦虑量表(HAMA)评定焦虑症状、用副反应量表(TESS)评定治疗4周末、8周末、12周末的药物不良反应.结果 Y-BOCS总分治疗前、治疗4周末两组间差异无统计学意义(P＞0.05),治疗8周末、12周末两组间差异有统计学意义(P＜0.05); HAMA总分治疗前两组差异无统计学意义(P＞0.05),治疗4周末、8周末、12周末差异均有统计学意义(P＜0.05);治疗4周末、8周末、12周末两组间TESS总分差异均无统计学意义(P＞0.05).结论 舍曲林联合阿立哌唑治疗强迫症效果良好,不良反应无增加.     

Influence of aripiprazole and olanzapine on behavioral dysfunctions of adolescent rats exposed to stress in perinatal period

BackgroundSchizophrenia is a group of mental disorders of unclear origin, affecting around 1% of global population, most commonly young people. Of various treatment methods, pharmacotherapy using atypical neuroleptics such as aripiprazole (ARI) and olanzapine (OLA) seems to be the most effective. The aim of this paper was to show that prenatal stress causes impairment of cognitive functions in adolescent rats.MethodsThe effect of chronic stress used in pregnant rats and the use of drugs such as ARI (1.5 mg/kg) and OLA(0.5 mg/kg) were studied in the Morris Water Maze (spatial memory) and Porsolt test (antidepressant effect).ResultsThe behavioral tests showed that ARI improved spatial memory both in the non-stressed control group (NSCG) (after single and chronic treatment) and in the prenatally stressed group (PSG) (only in 14 and 21 days of treatment). An antidepressant effect was observed in the NSCG (only in 1 and 7 days) and the PSG (after single and chronic administration). OLAalso showed memory improvement in the NSCG (chronic treatment – 14 and 21 days) and the PSG (all days of treatment) rats, but the antidepressant effect was noted only in single administration in both study groups (NSCG and PSG).Conclusion(s)Results suggest that ARI and OLA may prove effective in treating both schizophrenia and depression and may improve disturbed memory functions observed in these diseases.     

Beneficial acute antidepressant effects of aripiprazole as an adjunctive treatment or monotherapy in bipolar patients unresponsive to mood stabilizers: results from a 16-week open-label trial

Objective: Several lines of research suggested that aripiprazole might be a useful treatment for acute bipolar depression. The aim of this open-label trial is to give more evidence of the clinical effectiveness and tolerability of aripiprazole in acute bipolar depression. Research design and methods: Aripiprazole response was prospectively assessed for 16 weeks using the Montgomery-Asberg Depression Rating Scale (MADRS), the Clinical Global Impression Severity Scale (CGI-S), and the Young Mania Rating Scale in 85 bipolar patients with acute depression inadequately responsive to one mood stabilizer. Main outcome measures: Aripiprazole was well tolerated. Only three (3.5%) patients discontinued the study for side effects. The most common side effect was akathisia, occurring in 17/80 (21.2%) patients. Patients showed statistically insignificant weight gain (0.9 ± 2.64 kg) over the 16-week trial. Results: Patients showed a significant decrease in mean MADRS and CGI-S, and 80 (94.1%) patients completed the 16-week trial. Thirty-nine (45.8%) patients received aripiprazole as monotherapy and 46 received the drug adjunctively (54.1%). Fifty-two (65%) patients met criteria for response (≥ 50% reduction in MADRS total score), 30 (37.5%) patients met criteria for remission (final MADRS total score ≤ 12). Conclusions: Aripiprazole was associated with beneficial effects on mood in patients with bipolar depression, and appears well tolerated with very small changes in mean body weight. These results highlight the potential benefits of aripiprazole for bipolar disorder patients. However, double-blind, placebo-controlled studies are necessary to confirm aripiprazole's efficacy, tolerability and safety in bipolar depression.     

阿立哌唑与坦度螺酮联合应用改善女性精神分裂症患者认知功能

目的 探讨阿立哌唑和坦度螺酮联用对女性精神分裂症患者认知功能的影响.方法 91例女性精神分裂症患者随机分成两组,实验组(阿立哌唑联用坦度螺酮)47例,对照组(阿立哌唑)44例,治疗8周,在治疗前后采用阳性与阴性症状量表PANSS评定临床疗效,采用威斯康星卡片分类测验WCST以及注意广度测验评定认知功能,采用副作用量表TENSS评定不良反应.结果 治疗后两组PANSS评分较治疗前显著下降(P＜0.01).治疗后两组认知症状均有所改善.实验组认知测验中言语记忆、数字序列、持续操作、完成分类数高于对照组(P ＜0.05或0.01),错误应答数、非持续错误数低于对照组(P＜0.05或0.01).两组不良反应轻微,对照组患者出现震颤的例数显著增多(P＜0.05).结论 阿立哌唑联合坦度螺酮治疗精神分裂症可有效改善精神分裂症患者的认知功能.     

阿立哌唑治疗抗精神病药所致高催乳素血症的疗效观察

目的:验证合并使用小剂量阿立哌唑治疗抗精神病药(APS)所致高催乳素(PRL)血症的长期疗效及安全性。方法:对APS所致高PRL患者随机分为2组,一组继续使用APS治疗,一组在APS基础上合并使用5 mg·d-1阿立哌唑治疗。观察时间至少为26周。在基线及第4,8,12,26周末进行临床总体印象量表——严重程度(CGI-S)、锥体外系症状评定量表(ESRS)、血清PRL水平测定,记录停药率及停药前服药时间(TTD)。结果:阿立哌唑组PRL在第4周末即明显下降,到第8周末达到稳定水平;对照组患者PRL水平无变化。阿立哌唑组在26周时的停药率为11.1%,对照组26周时停药率为31.1%;阿立哌唑组在第52周时停药率为57.8%,对照组为76.7%;阿立哌唑组与对照组患者停药前的服药时间有显著差异[(297.3±92.6)d vs(193.5±103.1)d,t=6.86,P=0.001]。结论:合并小剂量阿立哌唑治疗抗精神病药所致高催乳素血症的长期效应好,安全性高。