利培酮或喹硫平治疗女性首发精神分裂症患者12个月中血清催乳素及体重变化的随机对照研究(英文)

背景:血清催乳素升高和体重增加是非典型抗精神病药物常见的副作用,但很少有研究评估这些副作用的长期情况。目标:比较利培酮或喹硫平治疗女性首发精神分裂症患者12个月后对血清催乳素及体重变化的影响。方法:80例女性首发精神分裂症住院患者被随机分配接受利培酮(N=40)或喹硫平(N=40)为期12个月的治疗。在开始治疗前一天和开始治疗后第1,3,6,9和12个月分别进行催乳素浓度,体重和身高的测定。在每一个时间段同时采用阳性和阴性症状量表(PANSS)评估症状的严重程度。结果:利培酮组31例患者和喹硫平组33例患者完成12个月的治疗。两组PANSS评分在每次后续的评估中都有所下降;利培酮组在治疗3个月和6个月时的改善显著,但在治疗第9个月两组的水平改善相似。喹硫平组血清催乳素在12个月内保持稳定,但利培酮组的血清催乳素水平在一年的随访中升高3.5至5.2倍。两组均出现体重增加,特别是在治疗的头3个月:两组的体重指数在治疗3个月时增加了62%。体重变化组间没有显著差异。体重变化和催乳激素水平变化之间的相关性呈弱阳性:利培酮组rs=0.17(p=0.104),喹硫平组r=0.07(p=0.862)。结论:虽然利培酮更迅速有效,但利培酮和喹硫平在治疗首发精神分裂症的第一年有相似的疗效。慢性高泌乳素血症与利培酮使用有关,但喹硫平没有。长期服用这两种药物与体重持续增加有关;两种药物在体重增加的时间性和幅度上相似。体重增加和催乳素水平变化不是密切相关的。

Randomized controlled trial comparing changes in serum prolactin and weight among female patients with first-episode schizophrenia over 12 months of treatment with risperidone or quetiapine

Background：Increased serum prolacitn and weight gain are common side effects of atypical anitpsychoitcs but few studies have assessed the long-term pattern of these adverse effects. Aim：Compare the effects of risperidone and queitapine on serum prolacitn and weight over 12 months of treatment among female paitents with ifrst-episode schizophrenia. Methods：Eighty female inpatients with first-episode schizophrenia were randomly assigned to receive risperidone （n=40） or quetiapine （n=40） for 12 months. Prolactin concentration, weight and height were measured one day before staritng treatment and 1, 3, 6, 9 and 12 months atfer iniitaitng treatment. Severity of symptoms was assessed at the same time periods using the Positive and Negative Syndrome Scale （PANSS）. Results：Thirty-one patients in the risperidone group and 33 patients in the quetiapine group completed the 12 months of treatment. PANSS scores decreased at each follow-up assessment for both groups;the improvement was signiifcantly greater in the risperidone group atfer 3 months and 6 months of treatment but by the 9th month of treatment the level of improvement in the two groups was similar. In the queitapine group serum prolacitn remained stable throughout the 12 months but in the risperidone group the serum prolacitn level increased 3.5-to 5.2-fold over the one-year follow-up. Weight gain was seen in both groups, paritcularly during the ifrst 3 months of treatment：62%of the increase in BMI in both groups had occurred by the end of the 3rd month of treatment. No between-group differences in weight changes were observed. The correlaiton between changes in weight and changes in prolacitn levels were weakly posiitve：rs=0.17 （p=0.104） in the risperidone group and r=0.07 （p=0.862） in the queitapine group. Conclusions：Risperidone and queitapine had similar effcacy in the ifrst year of treatment of ifrst-episode schizophrenia though risperidone was more rapidly effecitve. Use of risperidone was associated with chronic hyperpro