Switching to aripiprazole in subjects with pervasive developmental disorders showing tolerability issues with risperidone.
Switching to aripiprazole in subjects with pervasive developmental disorders showing tolerability issues with risperidone.
复制标题
对于患有广泛性发育障碍且对利培酮表现出耐受性问题的受试者改用阿立哌唑。
DOI：
10.1016/j.pnpbp.2011.12.015
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Ishitobi M et al.,
中科院分区：
文献类型：
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作者：
Nkouawa A;Sako Y;Li T;Chen X;Nakao M;Yanagida T;Okamoto M;Giraudoux P;Raoul F;Nakaya K;Xiao N;Qiu J;Qiu D;Craig PS;Ito A.;Ishitobi M et al.,
背景广泛性发育障碍（PDD）患者经常表现出攻击性和易怒等行为症状，这是精神药物干预的目标。本回顾性研究旨在检查患有PDD的儿童和青少年对利培酮治疗的耐受性问题，从而评估改用阿立哌唑的疗效和耐受性。方法本研究纳入符合DSM-IV诊断标准的PDD患者23例（男16例，女7例，年龄9 ~ 24岁，平均年龄15.1±3.9岁），从利培酮改用阿立哌唑后随访14.9±8.4周。结果测量为临床总体印象严重程度（CGI- s）和CGI改善（CGI- i）量表。结果阿立哌唑治疗前和治疗后的平均CGI-S评分分别为4.7±1.4和4.6±1.3。利培酮和阿立哌唑的平均维持剂量分别为0.7±0.5mg/d和2.8±1.3mg/d。整个样本的CGI-I平均评分为3.4±0.8，显示由利培酮转为阿立哌唑后的差异，说明阿立哌唑维持了利培酮治疗PDD行为问题的疗效。改用阿立哌唑后，出现了一些安全性/耐受性问题的改善，如食欲增加、嗜睡、高催乳素血症和闭经。结论阿立哌唑对PDD患者的耐受性一般较好，可作为对利培酮有耐受性问题的PDD患者的替代治疗方法。应该对PDD受试者进行额外的长期对照研究，以评估从其他抗精神病药物改用阿立哌唑的有效性和安全性。
BACKGROUNDSubjects with Pervasive Developmental Disorders (PDD) often exhibit behavioral symptoms such as aggressiveness and irritability, which are targets of psychopharmacologic intervention. This retrospective study was designed to examine children and adolescents with PDD experiencing tolerability issues with risperidone treatment, and thereby assess the efficacy and tolerability of switching to aripiprazole.METHODSThis naturalistic study included 23 subjects with PDD (16 males, 7 females, age range 9–24years, mean age 15.1±3.9years) diagnosed according to DSM-IV criteria and followed up for 14.9±8.4weeks after switching to aripiprazole from risperidone. Outcome measures were the Clinical Global Impression-Severity (CGI-S) and CGI Improvement (CGI-I) scales.RESULTSThe mean CGI-S scores of pre-aripiprazole treatment and post-aripiprazole treatment were, respectively 4.7±1.4 and 4.6±1.3. Mean maintenance dosages of risperidone and aripiprazole were, respectively, 0.7±0.5mg/day and 2.8±1.3mg/day. The mean CGI-I score, which shows the difference induced by switching from risperidone to aripiprazole, was 3.4±0.8 for the whole sample, suggesting that the efficacy of risperidone for treating behavioral problems of PDD was maintained by aripiprazole. Some improvement of safety/tolerability issues such as increased appetite, somnolence, hyperprolactinemia, and amenorrhea occurred after switching to aripiprazole.CONCLUSIONResults show that switching to aripiprazole might be generally well tolerated and might constitute an alternative treatment for subjects with PDD who experience tolerability issues with risperidone treatment. Additional long-term controlled studies of PDD subjects should be undertaken to evaluate the efficacy and safety of switching to aripiprazole from other antipsychotics.