Effects of clozapine on positive and negative symptoms in outpatients with schizophrenia.
Effects of clozapine on positive and negative symptoms in outpatients with schizophrenia.
复制标题
氯氮平对门诊精神分裂症患者阳性和阴性症状的影响。
DOI：
10.1176/ajp.151.1.20
复制
发表时间：
1994
期刊：
影响因子：
--
通讯作者：
CarpenterJr,WT
中科院分区：
文献类型：
--
作者：
Breier,A;Buchanan,RW;Kirkpatrick,B;Davis,OR;Irish,D;Summerfelt,A;CarpenterJr,WT
目的氯氮平是一种非典型精神安定药，对于重症、难治性住院精神分裂症患者疗效显着。为了确定氯氮平的差异疗效是否适用于病情较轻的门诊患者群体，作者检查了氯氮平对门诊精神分裂症患者阳性和阴性症状的影响。方法对传统精神安定药有部分反应史且对氟奋乃静前瞻性 6 周试验没有反应的精神分裂症门诊患者参加了为期 10 周的双盲平行组比较氯氮平和氟哌啶醇。 13 名男性和 6 名女性接受了氯氮平治疗，15 名男性和 5 名女性接受了氟哌啶醇治疗。确定了临床反应率，并讨论了对原发性与继发性阴性症状的影响。 10周试验结束时氯氮平和氟哌啶醇的剂量分别为410.5毫克/天（SD = 45.8）和24.8毫克/天（SD = 5.5）。结果氯氮平在治疗阳性症状方面优于氟哌啶醇。此外，八名接受氯氮平治疗的患者和仅一名接受氟哌啶醇治疗的患者符合临床反应者标准。氯氮平在治疗阴性症状方面也优于氟哌啶醇，尽管这些影响相对较小。阴性症状在非缺陷性精神分裂症患者亚组中受到显着影响，但在缺陷性精神分裂症亚组中则没有显着影响。总体而言，氯氮平的耐受性良好。 结论 氯氮平对于治疗部分缓解的慢性精神分裂症门诊患者的阳性症状具有优异的疗效，这表明它对除最严重病情的精神分裂症患者外还有广泛的用途。
ObjectiveClozapine is an atypical neuroleptic with superior efficacy in severely ill, treatment-resistant inpatients with schizophrenia. To determine if clozapine's differential efficacy generalizes to less ill, outpatients populations, the authors examined the effects of clozapine on positive and negative symptoms in outpatients with schizophrenia.MethodOutpatients with schizophrenia who had histories of partial response to conventional neuroleptics and who had not responded to a prospective 6-week trial of fluphenazine participated in a 10-week, double-blind, parallel-groups comparison of clozapine and haloperidol. Thirteen men and six women were given clozapine, and 15 men and five women were given haloperidol. Clinical response rates were determined and effects on primary versus secondary negative symptoms were addressed. Doses of clozapine and haloperidol at the end of the 10-week trial were 410.5 mg/day (SD= 45.8) and 24.8 mg/day (SD= 5.5), respectively.ResultsClozapine was superior to haloperidol for treating positive symptoms. In addition, eight of the patients given clozapine and only one of the patients given haloperidol fulfilled clinical responder criteria. Clozapine was also superior to haloperidol for treating negative symptoms, although these effects were relatively minor. Negative symptoms were significantly affected in the subgroup of patients with nondeficit schizophrenia but not in the subgroup with deficit schizophrenia. Overall, clozapine was well tolerated.ConclusionsClozapine has superior efficacy for treating positive symptoms in partially responsive outpatients with chronic schizophrenia, suggesting that it has utility for a broad spectrum of patients with schizophrenia beyond the most severely ill.