奥氮平与氟哌啶醇治疗老年谵妄的随机对照研究

目的探讨非典型抗精神病药物奥氮平与传统抗精神病药物氟哌啶醇治疗老年谵妄的疗效和安全性。方法收集在我院住院的老年谵妄患者196例,随机分为奥氮平组(80例)、氟哌啶醇组(76例)和对照组(40例),3组分别治疗7 d,治疗前后用简明精神病评定量表、临床总体印象量表严重程度评定疗效,用副反应量表评定不良反应和安全性。结果奥氮平组、氟哌啶醇组和对照组治疗的显效率分别为83.75%、80.26%和27.5%,差异有统计学意义(P0.01),奥氮平与氟哌啶醇组比较,差异无统计学意义(P0.05)。奥氮平组不良反应发生率为18.75%,氟哌啶醇组为55.26%,2组比较差异有统计学意义(P0.01)。结论奥氮平治疗谵妄患者疗效与氟哌啶醇相当,但副作用少,耐受性好,且安全有效,可替代传统抗精神病药用于谵妄治疗。

Randomly controlled study of olanzapine and haloperidol in the treatment of delirium in elderly

Objective To compare the efficacy and safety of atypical antipsychotics olanzapine and traditional antipsychotics haloperidol in treatment of delirium in elderly.Methods 196 elderly patients with delirium were randomly divided into three groups:olanzapine group (n = 80),haloperidol group (n= 76)and control group (n = 40).The three groups were separately treated for 7 days.Assessment of efficacy was made with Brief Psychiatric Rating Scale and Clinical Global Impression Scale.Treatment Emergent Symptom Scale was used to evaluate adverse reactions and safety.Results The treatment effective rates in olanzapine group,haloperidol group and control group were 83.75%,80.26% and 27.5% respectively.In comparison between the three groups, the difference was statistically significant (P < 0.01).The difference between olanzapine group and haloperidol group was not statistically significant (P > 0.05).The total incidence rate of side effects in olanzapine group was 18.75%,that of haloperidol group was 55.26%,with statistical significance in the difference between the two groups (P < 0.01).Conclusion The treatment of delirium with olanzapine in elderly is safe and effective.It has similar efficacy to haloperidol in treatment of delirium in elderly.However,olanzapine has fewer side effects.As patients have good tolerance,olanzapine can take the place of traditional antipsychotics.