赛庚定治疗利培酮所致高催乳素血症31例

Cyproheptadine in the Treatment of Hyperprolactinemia Caused by Risperidone in 31 Cases of Schizophrenia

目的 探讨赛庚定（CYP）治疗利培酮所致精神分裂症患者血清催乳素（PRL）升高的疗效及不良反应。方法选择符合CCMD-3诊断标准，年龄18～40岁，首次发病住院的精神分裂症患者。入院患者单一服用利培酮，第3周末检测PRL，PRL≥26．8ng·mL^-1者作为入组对象，共31例男性患者。入组当日即口服CYP18mg·d^-1，po，tid，持续2周。服CYP期间利培酮的剂量不变。第5周末检测PRL。实验期间有睡眠障碍者允许口服氯硝地西泮，剂量控制在4mg·d^-1内，记录不良反应。结果31例患者入组时PRL平均为（52．25±17．36）ng·mL^-1，治疗后PRL平均为（25．52±5．77）ng·mL^-1，差值平均为（26．96±16．90）ng·mL^-1，PRL比治疗前有明显的下降（P〈0．01），且无明显的不良反应。结论CYP治疗利培酮所致PRL升高安全有效。

Objective To study the therapeutic effect of cyproheptadine （CYP） on the hyperprolactinemia caused by risperidone in the treatment of patients with schizophrenia. Methods Male inpatients with fist-episode schizophrenia meeting the CCMD-3 diagnostic criteria were treated with risperidine PO. The patients were 18 -40 years old. Serum prolactin concentrations were determined in these patients at the end of the 3rd week of the treatment course. 31 patients whose serum prolactin concentrations were 26.8 ng · mL^-1 or higher were chosen as the subjects of the present study. They were given each 18 mg CYP PO q.d. for 5 consecutive weeks. During this period, dosage of risperidine in these patients remained unchanged. At the end of the 5^th week of the treatment course, serum prolactin levels were determined once again. During the CYP treatment course, patients suffering from sleep disturbances were allowed to take clonazepam at a dose lower than 4 mg · d^-1 Adverse reactions were registered. Results At the end of the 5 week CYP treatment course, a dramatic fall of the levels of serum prolactin from the pre-treatment concentration of （52.25 ± 17.30） ng · mL^-1 to the post-treatment one of （25.52 ± 5.77） ng · mL^-1（ p 〈 0.01 ） was demonstrated in these 31 patients. No major adverse reactions were encountered. Conclusion CYP was shown to be effective and safe in the treatment of hyperprolactinemia caused by risperidone.