丙米嗪治疗精神分裂症阴性症状的疗效

Effect of Imipramine in the Treatment of Negative Symptoms of Schizophrenics

目的 :了解丙米嗪对精神分裂症阴性症状的疗效。方法 :阴性症状为主的住院精神分裂症患者 40例 ,治疗组 2 0例在原用抗精神病药基础上加用丙米嗪治疗 ,开始 5 0mg·d 1 ,逐渐加量 ,第 1周加至 10 0mg·d 1 ,第 2周为 15 0mg·d 1 ,第 3周为 2 0 0mg·d 1 ,最大剂量不超过 2 0 0mg·d 1 ,均分早、午两次服用 ,共治疗 8周。对照组 2 0例仍用原抗精神病药物治疗。以阴性症状量表评分 (SANS)、阳性症状量表评分 (SAPS)、不良反应量表评分 (TESS)进行评定。结果 :两组患者SANS总分及各分量表评分治疗前后均差异无显著性 (P >0 .0 5 ) ,其余量表评分两组间比较亦均差异无显著性 (P >0 .0 5 )。结论 :丙米嗪对精神分裂症阴性症状无明显疗效。

Objective:To servey the therapeutic effectiveness of imipramine in the treatment of negative symptoms of schizophrenics. Methods:40 patients with schizophrenia manifesting predominantly negative symptoms were randomly divided into 2 equal groups, the study group and control group. On the basis of conventional antipsychotic therapy, patients of the study group (n=20) were treated additionally with imipramine. They were given each 50 mg·d -1 of imipramine PO as an initial dose. According to the patients' condition, the dose of imipramine was gradually increased to 100, 150 and 200 mg PO in the 1st, 2nd and 3rd week, respectively. The daily dose of imipramine was not allowed to exceed 200 mg. In all cases, the drug was given in 2 divided doses: in the morning and at noon. The course of treatment lasted 8 weeks. Patients of the control group(n=20) were subjected only to treatment with conventional antipsychotics. Scale for assessment of negative symptoms(SANS), scale for assessment of positive symptoms(SAPS) and treatment emergent symptom scale(TESS) were used to appraise the effects of the treatment. Results:As shown by SANS total scores and all subscale scores, the differences between the negative symptoms of patients of the study group before and after the treatment were insignifcant(P>0.05). Likewise,differences between the negative symptoms of the two group of patients were also insignificant(P>0.05).Differences between the positive symptoms of the two groups before and after the treatment were also insignificant(P>0.05),as shown by the SAPA total scores.Differences between the adverse reactions of the two group of patients were insignificant too (P>0.05), as shown by TESS scores. Conclusion:Imipramine was shown to have no apparent effect in the treatment of negative symptoms of schizophrenics.