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題名 | 固定及低劑量Risperidone 於急性惡化精神分裂症病患之療效研究=Risperidone Dose Adjustment in the Treatment of Acutely Exacerbated Schizophrenia |
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作者 | 邱偉哲; 藍先元; 李淑紅; 陳喬琪; 胡維恆; 張文和; | 書刊名 | 臺灣精神醫學 |
卷期 | 13:3 1999.09[民88.09] |
頁次 | 頁25-32 |
分類號 | 418.21 |
關鍵詞 | 精神分裂症; 急性惡化; Risperidone; Schizophrenia; Acute exacerbation; |
語文 | 中文(Chinese) |
中文摘要 | 目的:Risperidone為一非典型抗精神病藥物。本研究以31位急性惡化之精神分裂 症住院患者,接受risperidone 6週的治療結果,來評估risperidone的療效與副作用。方法: 本研究採開放性研究設計。若患者可耐受副作用,在3日內以每日增加2 mg的方式增加至 目標劑量6 mg/day,否則可調低目標劑量;第4日後若仍有副作用,可繼續降低劑量。結果: 在完成的30位病患中活性與負性症狀量表中總分、活性、負性及精神病理症狀分別改善 26.9%、33.0%、22.5%及25.8%;有七成(21位)病患對治療反應良好(活性與負性症狀量表總 分至少降低20%)。30位病患中有17位的劑量維持在6 mg/day,其中有9位(52.7%)對治療 反應良好;30位病患中也有13位因副作用須降低終劑量至2-5 mg/day (3.6±0.9 mg/day), 其中高達12位(92.3%)對治療反應良好,反應良好的比率較固定劑量組來得高。副作用方面, 以錐體外徑副作用、體重增加、及心跳加速最常出現。結論:Risperidone對多數急性惡化 之精神分裂症住院病患具有療效。若病患無法耐受6 mg/day的目標劑量,適度降低劑量以 減除副作用仍可得到相當的療效。 |
英文摘要 | Objective: Risperidone, an atypical antipsychotic drug, has been demonstrated to be as effective as typical antipsychotics in the treatment of schizophrenia. The purpose of this trial was to investigate the efficacy of fixed and low doses of risperidone in the treatment of acutely exacerbated schizophrenic patients in Taiwan. Methods: Acutely exacerbated schizophrenic inpatients were treated with risperidone in this 6-week, open-label study. Doses were titrated to 3 mg b.i.d. over 3 days. The doses were reduced if patients experienced intolerable side effects. Efficacy was measured using the Positive and Negative Syndrome Scale (PANNSS). Side effects were evaluated with the Extrapyramidal Symptom Rating Scale and the UKU (Udvalg for Kliniske Undersogelser) scale. Results: A total thirty one patients are enrolled in the study. One man dropped out the study because of refusal of admission. Thirteen women and seventeen men, with a man (±SD) age of 36.1(±9.6) years completed the experimental regimen. Among these 30 patients, 17 tolerated the 6-mg target dose well, while the other 13 received lower final doses (mean 3.6±0.9 mg, p<0.005) because of the development of emergent treatment-related side effects. At endpoint, the low-dose group tended to excel, albeit statistically insignificantly, in terms of percentage changes in the PANSS total and 3 PANSS subscales. A significantly higher percentage of low-dose patients than fixed-dose individuals responded to treatment (20% or more reduction in the PANSS total) (92.3% vs. 52.9%, p<0.05). Conclusions: The results of this study suggest that risperidone might be efficacious in the treatment of acutely exacerbated schizophrenic patients. Most patients (around 60%) in the present series could tolerate the target dose of 6 mg/day well. Among the remaining 40% of subjects, lower dosages (3.6 ±0.9 mg/day) could reduce adverse events and still provide effective reduction in PANSS.(Full Text in Chinese) |
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