Minimal maintenance medication: effects of three dose schedules on relapse rates and symptoms in chronic schizophrenic outpatients.
Minimal maintenance medication: effects of three dose schedules on relapse rates and symptoms in chronic schizophrenic outpatients.
复制标题
最低维持药物：三种剂量方案对慢性精神分裂症门诊患者复发率和症状的影响。
DOI：
10.1016/0010-440x(83)90057-3
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发表时间：
1983
影响因子：
7.3
通讯作者：
M. Deutsch
中科院分区：
文献类型：
--
作者：
H. Lehmann;W. Wilson;M. Deutsch
我们的一般假设是，较低剂量的抗精神病药物比通常使用的可能不仅是足够的许多精神分裂症患者的维持治疗，但也可能降低神经毒性作用的风险。为了探讨这种剂量减少的后果，94例慢性精神分裂症门诊患者被随机分为三组：（1）继续常规维持剂量;（2）接受药物减少到相当于每天100 mg的氯丙嗪，（3）接受剂量减少到相当于只有50 mg的氯丙嗪。进行了为期12个月的开放性临床试验。12个月期间的不同复发率为：常规剂量（平均值= 609 mg/天）为21.4%; 100 mg为32.2%; 50 mg为25.8%。这些差异无统计学显著性，但存在偏倚，表明一些病情较轻的患者进入了较低剂量组。然而，我们的研究结果表明，在稳定的精神分裂症患者中，即使是非常低剂量的抗精神病药物维持治疗也可能产生有用的效果，我们估计这一效果不到未用药患者复发率的一半。此外，较低剂量的抗精神病药物可能产生其他有益作用，可能反映了锥体外系和其他神经毒性作用的减少。
Our general hypothesis was that lower doses of antipsychotic agents than are usually employed may not only be adequate for the maintenance treatment of many schizophrenic patients but may also reduce the risk of neurotoxic effects. To explore the consequences of such dosage reductions, 94 chronic schizophrenic outpatients were randomly divided into three groups: (1) continuing on the regular maintenance dosage; (2) receiving medication reduced to the equivalent of 100 mg of chlorpromazine a day, and (3) receiving doses reduced to the equivalent of only 50 mg of chlorpromazine. An open clinical trial was conducted for 12 mo. The different rates of relapse during the 12-mo period were: 21.4% at the regular dose (mean = 609 mg/day); 32.2% at 100 mg, and 25.8% at 50 mg. These differences were not statistically significant, although there was bias encountered, suggesting that some less severely ill patients entered the lower dose groups. Nevertheless, our findings suggest that, in stabilized schizophrenic patients, even very low doses of antipsychotic maintenance medication may exert useful effects that we estimate to represent less than a half of the relapse rate expected in nonmedicated patients. In addition, lower doses of antipsychotic medication may exert other beneficial effects, possibly reflecting a reduction of extrapyramidal and other neurotoxic actions.