奥卡西平辅助治疗精神分裂症及分裂样精神病兴奋躁动的比较研究

Efficacy and safety of oxcarbazepine as adjuvant therapy in excited patients with schizophrenia and schizophreniform psychosis

目的评估奥卡西平治疗兴奋躁动精神分裂症、分裂样精神病辅助疗效和安全性。方法将符合中国精神障碍分类与诊断标准第3版中精神分裂症、分裂样精神病诊断标准,并以兴奋躁动为主要表现的80例患者随机分为研究组(n=39)和对照组(n=41),研究组应用抗精神病药物(氯氮平、奥氮平、利培酮、喹硫平、阿立哌唑或齐拉西酮其中之一)联合奥卡西平,对照组单一使用抗精神病药物,观察6周。采用简明精神病量表(BPRS)和阳性和阴性综合征量表(PANSS)兴奋因子,不良反应量表(TESS)在治疗前及治疗后第1,2,4,6周分别评估疗效和安全性。结果治疗6周后,研究组有效28例(71.8%),对照组有效26例(65.0%),2组有效率差异有统计学意义(χ2=6.02,P=0.028)。研究组与对照组患者分别脱落2例和4例。研究组的主要不良反应为镇静(11例)、便秘(10例)、头晕(7例)、心动过速(7例)等,对照组的主要不良反应为便秘(14例)、口干(12例)、心动过速(12例)、锥体外系不良反应(7例)等。结论奥卡西平能有效辅助治疗精神分裂症、分裂样精神病的兴奋状态。

Objective： To evaluate efficacy and safety of oxcarbazepine as adjuvant therapy in excited patients with schizophrenia and schizophreniform psychosis. Methods： Eighty patients met CCMD -3 criteria for schizophrenia and schizophreniform psychosis and dominated with excitement and agitation were randomized to study group （ n = 39） and control group （ n =41 ）. Patients in study group were treated with one antipsychotic agent （any of clozapine, olanzapine, risperidone, quetiapine, aripiprazole or ziprasidone） and oxcarbazepine, whereas patients in control group were treated with one antipsychotic agent only. All patients were treated for 6 weeks and assessed before and at the end of week 1, 2, 4 and 6 of treatment, with efficacy measured by brief psychiatric rating scale （BPRS） and positive and negative syndrome scale （PANSS） excitement items and safety measured by treatment emergent symptom scale （TESS）. Results：At week 6 of treatment, response rate was significantly different （X^2 =6.02, P=0.028 ） between study group （ 71.8%, n=28） and control group （ 65%, n = 26 ）. Number of drop - out patients was 2 in study group and 4 in control group. Drop - out rate was not significantly different between 2 groups. Common adverse effects included sedation （ n = 11 ）, constipation （n = 10）, dizziness （n =7）, tachycardia （n =7） in study group and constipation （n = 14）, dry mouth （n = 12）, tachycardia （ n = 12） and extrapyramidal symptoms （ n = 7 ） in control group. Conclusion： Oxcarbazepine is effective and safe as adjuvant therapy in excited patients with schizophrenia and schizophreniform psychosis.