Short-term treatment with risperidone or haloperidol in first-episode schizophrenia: 8-week results of a randomized controlled trial within the German Research Network on Schizophrenia.
Short-term treatment with risperidone or haloperidol in first-episode schizophrenia: 8-week results of a randomized controlled trial within the German Research Network on Schizophrenia.
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利培酮或氟哌啶醇短期治疗首发精神分裂症：德国精神分裂症研究网络随机对照试验的 8 周结果。
DOI：
10.1017/s1461145708008791
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
W. Gaebel
中科院分区：
文献类型：
--
作者：
H. Möller;M. Riedel;M. Jäger;Florian Wickelmaier;W. Maier;K. Kühn;G. Buchkremer;I. Heuser;J. Klosterkötter;M. Gastpar;D. Braus;R. Schlösser;F. Schneider;C. Ohmann;M. Riesbeck;W. Gaebel
首发精神分裂症患者似乎对较低剂量的抗精神病药有反应，并且对锥体外系副作用更敏感。因此，作者比较了这些患者相对低剂量的非典型抗精神病药利培酮和常规抗精神病药氟哌啶醇的疗效和锥体外耐受性。假设利培酮在治疗阴性症状方面具有更好的锥体外耐受性和疗效。患者在双盲条件下随机分配接受利培酮（n=143）或氟哌啶醇（n=146）治疗8周。主要疗效标准为治疗组间阳性和阴性症状量表（PANSS）阴性评分平均变化的估计差异；次要疗效标准是PANSS总分和其他PANSS分值的变化，以及其他一些精神病理和一般功能的测量。主要的耐受性标准是用Simpson-Angus量表（SAS）测量的经基线调整的锥体外系副作用发生率的差异。主要的假设是利培酮在改善阴性症状和降低锥体外系症状的风险方面更优越。次要耐受性标准是其他锥体外系症状，用Hillside静坐量表（HAS）和异常不自主运动量表（AIMS）进行测量。利培酮的平均每日剂量为3.8 mg (sd =1.5)，氟哌啶醇为3.7 mg （sd =1.5）。两个治疗组在主要和次要疗效标准上有相似的显著改善。在第8周，几乎所有的锥体外系副作用评分都表明氟哌啶醇的锥体外系副作用发生率明显高于利培酮[SAS：利培酮36.5%；氟哌啶醇51.5%；似然比检验，χ 2(1)=7.8, p=0.005。退出组显著减少[利培酮n=55，退出率=38.5%；氟哌啶醇n=79，退出率=54.1%,chi2(1)=7.1, p=0.009]，且未停药时间较长[利培酮：平均50.8 d退出；氟哌啶醇：平均44.0 d退出；Log rank检验，ch2 (1)=6.4, p=0.011]。利培酮和氟哌啶醇在治疗阴性和其他首发精神分裂症症状方面似乎同样有效。在这些患者中，利培酮比同等剂量的氟哌啶醇具有更好的锥体外耐受性和治疗保留率。
Patients with first-episode schizophrenia appear to respond to lower doses of neuroleptics, and to be more sensitive to developing extrapyramidal side-effects. The authors therefore compared in such patients the efficacy and extrapyramidal tolerability of comparatively low dosages of the atypical neuroleptic risperidone and of the conventional neuroleptic haloperidol. Risperidone was hypothesized to have better extrapyramidal tolerability and efficacy in treating negative symptoms. Patients were randomly assigned under double-blind conditions to receive risperidone (n=143) or haloperidol (n=146) for 8 wk. The primary efficacy criterion was the estimated difference in the mean change in the Positive and Negative Symptom Scale (PANSS) negative score between treatment groups; secondary efficacy criteria were changes on the PANSS total score and other PANSS subscores, and several other measures of psychopathology and general functioning. The primary tolerability criterion was the difference in baseline-adjusted occurrence rates of extrapyramidal side-effects measured with the Simpson-Angus Scale (SAS) compared between treatment groups. The main hypothesis was that risperidone would be superior in terms of improving negative symptoms and lowering the risk of extrapyramidal symptoms. Secondary tolerability criteria were the other extrapyramidal symptoms, measured with the Hillside Akathisia Scale (HAS) and the Abnormal Involuntary Movement Scale (AIMS). The average mean daily doses were 3.8 mg (s.d.=1.5) for risperidone and 3.7 mg (s.d.=1.5) for haloperidol. There were similar, significant improvements in both treatment groups in the primary and secondary efficacy criteria. At week 8 nearly all scores of extrapyramidal side-effects indicated a significantly higher prevalence of extrapyramidal side-effects with haloperidol than with risperidone [SAS: risperidone 36.5% of patients; haloperidol 51.5% of patients; likelihood ratio test, chi2(1)=7.8, p=0.005]. There were significantly fewer drop-outs [risperidone n=55, drop-out rate=38.5%; haloperidol n=79, drop-out rate=54.1%, chi2(1)=7.1, p=0.009] and a longer non-discontinuation time [risperidone: average of 50.8 d to drop-out; haloperidol: average of 44.0 d to drop-out; log rank test, chi2(1)=6.4, p=0.011] in the risperidone group. Risperidone and haloperidol appear to be equally effective in treating negative and other symptoms of first-episode schizophrenia. Risperidone has better extrapyramidal tolerability and treatment retention rate than the equivalent dose of haloperidol in these patients.
Hillside 静坐不能量表：一种新的抗精神病药引起的静坐不能评定工具。
影响因子：
--
作者：
Fleischhacker,WW;Bergmann,KJ;Perovich,R;Pestreich,LK;Borenstein,M;Lieberman,JA;Kane,JM
通讯作者：
Kane,JM
DOI：
--
发表时间：
1996
期刊：
The Journal of clinical psychiatry
影响因子：
--
作者：
J. Lieberman;A. Koreen;M. Chakos;B. Sheitman;M. Woerner;J. Alvir;R. Bilder
通讯作者：
J. Lieberman;A. Koreen;M. Chakos;B. Sheitman;M. Woerner;J. Alvir;R. Bilder
影响因子：
158.5
作者：
Lieberman, JA;Stroup, TS;Hsiao, JK
通讯作者：
Hsiao, JK