Time to clozapine response in a standardized trial.
Time to clozapine response in a standardized trial.
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标准化试验中氯氮平反应的时间。
DOI：
10.1176/ajp.154.9.1243
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Tamminga,CA
中科院分区：
文献类型：
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作者：
Conley,RR;CarpenterJr,WT;Tamminga,CA
目的探讨精神分裂症难治性患者氯氮平的反应时间。方法对50例难治性精神分裂症住院患者进行氯氮平抗精神病药物疗效观察。受试者接受氯氮平治疗至少12个月，无论反应状态如何，均按照标准化的增加剂量方案。行为改变是通过每月一次的简短精神病学评定量表来测量的。结果34名受试者（68%）在试验结束时达到临床缓解标准。平均剂量为468 mg/天（SD= 168）时达到应答。30例（88%）应答患者的剂量为600mg /天或更少。平均反应时间为82天（SD= 100，范围= 10-401）。受试者平均需要60天（SD= 87）才能达到达到氯氮平反应的剂量。一旦达到该剂量，平均反应时间为17天（SD= 14，范围= 2-56）。所有34名受试者在氯氮平剂量增加后8周内均符合标准。其余16名受试者在平均随访75周（SD= 50）后未发现延迟反应。在这项研究中，所有对氯氮平有反应的患者在剂量改变后的8周内都有反应。因此，延长氯氮平暴露于任何特定剂量超过8周，如果没有反应，似乎没有什么临床获益。
ObjectiveThe authors sought to determine the time to clozapine response in treatment-refractory patients with schizophrenia.MethodAntipsychotic response to a clozapine trial was examined in 50 treatment-refractory schizophrenic inpatients. Subjects were treated with clozapine for at least 12 months, regardless of response status, according to a standardized, increasing dose protocol. Behavioral changes were measured through monthly assessments with the Brief Psychiatric Rating Scale.ResultsThirty-four subjects (68%) met clinical response criteria by the end of the trial. Response was achieved at a mean dose of 468 mg/day (SD= 168). The dose of 30 (88%) of the responding patients was 600 mg/day or less. The mean time to response was 82 days (SD= 100, range= 10–401). It took an average of 60 days (SD= 87) for subjects to reach the dose at which clozapine response was achieved. Once this dose was reached, the average response time was 17 days (SD= 14, range= 2–56). All 34 subjects who responded met criteria within 8 weeks of a clozapine dose escalation. No late response was found in the remaining 16 subjects despite a mean follow-up period of 75 weeks (SD= 50).ConclusionsIn this study, all patients who responded to clozapine did so within 8 weeks of a change in dose. Thus, there appears to be little clinical gain in prolonging exposure to clozapine beyond 8 weeks at any particular dose if no response is seen.