Fluphenazine plasma levels, dosage, efficacy, and side effects.
Fluphenazine plasma levels, dosage, efficacy, and side effects.
复制标题
氟奋乃静血浆浓度、剂量、功效和副作用。
DOI：
10.1176/ajp.152.5.765
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Stephanos,MJ
中科院分区：
文献类型：
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作者：
Levinson,DF;Simpson,GM;Lo,ES;Cooper,TB;Singh,H;Yadalam,K;Stephanos,MJ
作者试图确定是否氟奋乃静剂量或血浆水平预测临床改善或副作用在急性treatment.Methodoral氟奋乃静给予固定的，随机的，双盲剂量（10，20，或30毫克/天）为4周的72例急性精神分裂症急性加重的住院患者。结果指标包括阳性症状（幻觉、妄想和思维障碍）评分的改善百分比、阴性症状改善百分比和锥体外系症状最高评分。反应被定义为改善阳性症状的40%或以上。ResultsThe 42应答者有较短的病程，慢性病程，静坐不能率较低。血浆水平和剂量不能区分应答者和无应答者，但它们确实预测了应答者亚组中阳性症状的改善百分比。静坐不能是更常见的和锥体外系症状更严重，在较高的血浆levels.ConclusionsResponders表现出最大的改善，在氟奋乃静血浆浓度高于1.0 ng/ml，剂量高于0.20-0.25 mg/kg每天。由于文献表明急性和维持治疗期间的最佳血浆水平相似，因此监测血浆水平可能是有用的。在未来的研究中应用“只回答”的分析策略的条件进行了讨论。
ObjectiveThe authors sought to determine whether fluphenazine dose or plasma level predicts clinical improvement or side effects during acute treatment.MethodOral fluphenazine was given in fixed, randomized, double-blind doses (10, 20, or 30 mg/day) for 4 weeks to 72 inpatients with acute schizophrenic exacerbations. Outcome measures included percentage improvement in ratings of positive symptoms (hallucinations, delusions, and thought disorder), percentage improvement in negative symptoms, and maximum score for extrapyramidal symptoms. Response was defined as an improvement in positive symptoms of 40% or more.ResultsThe 42 responders had a shorter duration of illness, less chronic course, and lower rate of akathisia. Plasma level and dose did not differentiate responders and nonresponders, but they did predict percentage improvement in positive symptoms within the responder subgroup. Akathisia was more common and extrapyramidal symptoms were more severe at higher plasma levels.ConclusionsResponders showed the greatest improvement at fluphenazine plasma levels above 1.0 ng/ml and doses above 0.20-0.25 mg/kg per day. Since the literature suggests that optimal plasma levels are similar during acute and maintenance treatment, monitoring of plasma levels may thus be useful. Conditions for applying the" responder-only" analytic strategy in future studies are discussed.