小剂量氯氮平治疗苯二氮类药物滥用相关性失眠

Clinical Study on the Effect of Clozapine of the Low Does in the Treatment of the Benzodiazepine Abuse Related Insomnia

目的:探讨小剂量氯氮平治疗苯二氮类药物滥用相关性失眠的疗效和安全性。方法:应用小剂量(41.48±26.27mg/d,12.5～100mg/d)氯氮平治疗35例苯二氮类药物滥用相关性失眠患者,于治疗前、治疗后第2、4周末,分别采用匹茨堡睡眠质量指数(PSQI)中文定式问卷评定疗效、副反应量表(TESS)评定副反应,停药后随访4周。结果:使用小剂量氯氮平治疗前后PSQI评分有显著性差异(P<0.001)。主要不良反应为轻度口干、轻微流涎、乏力、嗜睡等。停药4周后反弹性失眠少。结论:在监测血象的前提下,使用小剂量氯氮平治疗苯二氮类药物滥用相关性失眠是一种快速、有效的方法,较为安全,

Objective： To explore the therapeutics effect and safety evaluation on when using the low does of clozapine to treat the benzodiazepine abuse related insomnia. Methods： The low doses of clozapine ranging from 12.5mg/d to 100mg/d with the average of 41.48±26.27mg/d were used to treat 35 patients who had been diagnosed as the benzodiazepine abuse related insomnia. Pittsburgh Sleep Quality Index （PSQI） and Treatment Emergent Symptom Scale （TESS） were respectively used to assess the treatment effect and the side effect before the starting therapy, the second weekend and the fourth weekend following the dosing of clozapine. Follow observation continued 4 weeks after stopping dosing the clozapine. Results： After given the low dose of clozapine, Scores patients were assessed accoring to PSQI had significant differences （P〈0.001） compared with before the clozapine treatment. The major side effects were xerostomia lightly, salivate, weary and hypersomnia, during the clozapine treatment. Few of patients displayed resilient insomnia after 4 weeks of discontinuation of the clozapine. Conclusions： In the precondition of monitoring hemogram, it is a rapid and effective method to use the low does of clozapine to treat the benzodiazepine abuse related insomnia ,and it is safety relatively.