Risperidone long-acting injectable in the treatment of treatment-resistant schizophrenia with dopamine supersensitivity psychosis: Results of a 2-year prospective study, including an additional 1-year follow-up
Risperidone long-acting injectable in the treatment of treatment-resistant schizophrenia with dopamine supersensitivity psychosis: Results of a 2-year prospective study, including an additional 1-year follow-up
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DOI：
10.1177/0269881116655978
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发表时间：
2016-08-01
影响因子：
4.1
通讯作者：
Iyo, Masaomi
中科院分区：
文献类型：
--
作者：
Kimura, Hiroshi;Kanahara, Nobuhisa;Iyo, Masaomi
抗精神病药物治疗引起的多巴胺超敏性精神病（DSP）与难治性精神分裂症（TRS）有关，其治疗至今尚未确定。通过利培酮长效注射剂（RLAI）维持多巴胺D2受体的完全稳定占据是一种治疗策略。在这项研究中，RLAI作为口服抗精神病药的替代药物，在一项为期2年的研究中，108例治疗抵抗患者部分逐渐转为RLAI，额外随访1年，并比较72例有DSP病史的患者（DSP组）和36例无DSP病史的患者（非DSP组）的效果。虽然两组在随访期间的简明精神病评定量表（BPRS）总分均显示出显著改善，但DSP组的改善程度大于NonDSP组。在整个研究期间，高剂量（> 850 mg氯丙嗪-口服抗精神病药和RLAI的联合剂量）在两组中均未发生显著变化;然而，锥体外系症状（包括迟发性运动障碍）仅在DSP患者中得到显著改善。这项研究强烈表明，RLAI治疗，即使只有部分转换，提供了缓解难治性症状，特别是对于有DSP病史的患者。
Dopamine supersensitivity psychosis (DSP) resulting from antipsychotic treatment is related to treatment-resistant schizophrenia (TRS), and its treatment has not been established to date. Maintaining thoroughly stable occupancy of the dopamine D2 receptor by risperidone long-acting injectable (RLAI) is one strategy for treatment. In this study, RLAI was given as an adjunctive medication to oral antipsychotic(s), which were switched partially and gradually to RLAI in 108 treatment-resistant patients for an additional 1-year follow-up in a 2-year study, and to compare the effects in 72 patients with a DSP history (DSP group) and 36 patients without this history (NonDSP group). Although both groups showed significant improvements in the total Brief Psychotic Rating Scale (BPRS) score during the follow-up period, greater improvement was observed for the DSP group than the NonDSP group. High doses (> 850 mg chlorpromazine-dose combined of oral antipsychotics and RLAI) did not significantly change in both groups throughout the study period; however, extrapyramidal symptoms, including tardive dyskinesia, were significantly improved only in the patients with DSP. This study strongly suggested that the RLAI treatment, even with only partial switching, provides relief from refractory symptoms, particularly for patients with a history of DSP.