住院慢性精神分裂症衰退期患者的停药观察

目的：探讨长期住院的慢性精神分裂症衰退期患者是否可以停用抗精神病药物。方法：符合慢性精神分裂症衰退期患者70例，逐步停服抗精神病药物，一般分2～3次逐步减量，最终完全停药；对停药过程中病情不稳者暂缓减量，分步逐年减量，一般在每年的夏天进行药物减量，共进行4年临床观察。用自制的《慢性精神分裂症服药观察表》每年对每位患者进行服药等一般情况的登记；用阳性和阴性症状量表（PANSS）、住院精神病人社会功能评定量表（SSPI）于入组前、人组后的每一年、结束时，对每一位患者进行精神症状和社会功能评定。结果：4年问，成功停药14人（占总人数21％），而大部分患者（53人，占79％）在药物减量过程中因病情有波动，故没有完成停药，仍需药物维持治疗。在停药的种类中氯氮平和利培酮没有成功停用，只完成减量。人组前后精神症状无明显恶化，PANSS量表的总分、阳性因子分、阴性因子分、一般病理因子分均呈减分趋势，差异有显著性（P〈0．01），社会功能（SSPI）在减药过程中无明显变化（P〉0．05）。结论：慢性精神分裂症衰退期患者有小部分人可以停用抗精神病药物，而大多数仍需小剂量维持治疗。服氯氮平者多不适应停药。

The withdrawal observation of hospitalized patients with chronic schizophrenia recession

Objective：To investigate long- stay patients with chronic schizophrenia recession whether antipsychotic drugs can be disabled. Methods ：70 patients with chronic schizophrenia recession and gradually stop taking antipsychotics drugs, the gradual re- duction in 2 - 3 times , then final full withdrawal ; Unstable condition of the withdrawal process were suspended reduction, year by year reduction step, Usually in the summer of each year for drug reduction, a total of four years of clinical observation. Self - made ＂chron- ic schizophrenia medication observation form＂ for each medication for each patient registration and other general. With positive and negative syndrome scale （PANSS）, social function of mental patients Residential Rating Scale （SSPI） into the group in front, each year after enrollment, at the end of each patient were assessed psychiatric symptoms and social function. Results： Four years, success- fully stopping 14 （21% of the total number）, and most patients （53.79%） in the drug reduction process due to the disease fluctu- ates, and there is no complete withdrawal, medication maintenance treatment needed. Type in the withdrawal of clozapine and risperi- done did not successfully disabled, the only complete reduction. Into the group before and after no significant worsening of psychiatric symptoms, PANSS total score scale, the positive factor scores, and negative factor scores, general pathology factor scores showed a trend of reduced hours, the difference was statistically significant （P 〈0.01 ）, Social function （SSPI） in the course of medication in no significant changes （ P 〉 0.05 ）. Conclusions ： A small part of patients with chronic schizophrenia recession can be disable antipsy- chotic drugs, but most still need a small dose of maintenance therapy. The patients taking Clozapine are not suited to stopping drugs.