利培酮治疗210例首发精神分裂症开放研究

The Open Study of Risperdone in 210 First-episode Schizophrenics

为探讨利培酮对首发精神分裂症治疗的有效性、副反应、安全性及患者的依从性,对210例年龄范围在16岁～50岁,符合ICD-10、CCMD-2-R诊断标准的精神分裂症或分裂样精神障碍(分裂样精神病)的首发病人,病程<5年,BPRS总分≥27分,既往若应用抗精神病药连续治疗时间<8周,入组前未服用其它抗精神病药物者直接给药,若改用利培酮治疗者需停药一周以上。起始剂量为0.5～1.0mg/d,根据患者的病情和反应逐步加量,2周左右加大到治疗量,一般为2～4mg/d(因人而宜),连续观察期限定为8～16周并以简明精神病量表(BPRS)、临床总体印象量表(CGI)、副反应量表(TESS)进行评定。结果,临床痊愈和显著好转158例(75.2％),好转48例(22.86％),有效率为98.06％。副反应轻而发生率低共计44例,占20.95％,其中EPS25例,睡眠障碍11例,EKG改变、口干、恶心,肥胖、视力模糊等共8例,无1例因重度反应而停药者。提示,利培酮对首发精神分裂症病人的治疗显效率及有效率均高,对阳性和阴性症状有较好疗效,能改善认知功能,副反应少而轻,安全性、依从性好,是首发病人较理想的首选药物,可作为第一线药物应用。

To explore the effectiveness,side reaction, security and patient's compliance of risperdone in the treatment of first-episode schizophrenia, the open-study was conducted in 20 first-episode schizophrenics whose age ranged from 16 to 50 years old, diagnose met the criteria of schizophrenia or schizoid mental disorder(ICD-10,CCMD-R), course was less than 5 years,the total score of BPRS was >27 scores,and if an-tipsychotic drugs used the continuous time was less than 8 weeks. Drug was directly given to the patients who did'nt use other antipyschotic drugs before study,if risperdone was adopted instead whose treatment was stopped for more than one week. The initial dosage was 0. 5-1. Omg/d,dosage was increasingly added to therapeutic dosage generally ranged from 2 to 4 mg/g(to vary with indivdua1)about 2 weeks according to the patient's condition and reaction;the period of continuous observation was limited to 8-16 weeks, and assessments were conducted using BPRS CGI and TESS. It was found that 158 patients(75. 2%)showed clinical recovery and significant improvement, 48(22. 86%) improvement,and curative rate was (98. 06%);side reaction was mild and frequency low (n = 44, 20. 95%), among them 25 showed EPS, 11 did insomnia, and 8 did the change of EKG, xerostomia, nausea, obesity and blurring of vision, none stopped drug because of severe reaction. The results suggested that effective rate of risperdone in first-episode schizophrenia was higher, especially better on negative and positive symptoms,could improve cognitive function,side reactions fewer and mild,security and compliance better and was ideal drug of choice which could be used as first-line drug for first-episode patients.