氯氮平合并利培酮治疗难治性精神分裂症

Combined treatment of refractory schizophrenia with clozapine and risperidone

目的 :了解氯氮平合并利培酮治疗难治性精神分裂症的疗效和安全性。 方法 :2 6例符合 CCMD- 2 - R精神分裂症诊断标准且临床判断属于难治性病人 ,予氯氮平合并利培酮治疗 ,疗程 8周 ,分别在治疗前及治疗后进行阳性与阴性症状量表 (PANSS)和不良反应症状量表 (TESS)评定。 结果 :合并治疗 8周后总有效率为 6 5 .3%。 PANSS阳性 ,阴性及一般精神病理分治疗前后均有显著差异 (P<0 .0 1)。 TESS总分治疗前后无显著差异 (P>0 .0 5 )。副反应主要为静坐不能 ,肌张力增高 ,失眠 ,体重增加 ,视物模糊。 结论 :对于氯氮平治疗反应不佳的难治性精神分裂症病人合并利培酮治疗仍可取得较好的临床效果 ,安全性较高 ,耐受性及依从性好 ,可作为临床治疗难治性病人的方法之一。

Objective:To evaluate the efficacy and side effects of combined clozapine and risperidone in the treatment of refractory schizophrenia. Method:Twenty six patients with diagnosis of schizophrinia according to CCMD 2 R and proved refractory to standard treatment were treated with clozapine and risperidone for eight weeks. Subjects were assessed with the PANSS and TESS before and after treatment. Results:Overall successful rate after eight weeks was 65 3%. There were significant differences in the positive, negative and general psychopathology scores of PANSS between pre and post treatment(P<0 01). The main side effects were akathisia, increased muscle tone, insomnia, weight gain and blurred vision. Conclusion:Schizophrenic patients showing limited response to clozapine alone could gain further improvement with combined clozapine and risperidone treatment. Clients show good tolerance and compliance to the combination regime.