奎硫平与氯氮平治疗首发精神分裂症的疗效比较

Comparation of quetiapine and clozapine in treatment of patients with first-onset schizophrenia

目的 :比较奎硫平与氯氮平治疗首发精神分裂症的疗效与安全性。方法 :将首发精神分裂症患者 85例随机分为 2组 ,分别给予奎硫平与氯氮平治疗 ,其中奎硫平组 4 3例 ,平均剂量为 4 2 5±5 6mg·d-1;氯氮平组 4 2例 ,平均治疗剂量为 35 0±73mg·d-1,疗程共 8周。采用阳性与阴性症状量表(PANNS)及副反应量表 (TESS)在治疗前和治疗后第1、2、4、6、8周末分别评定疗效和不良反应。结果 :两组治疗后第 1、2、4、6、8周末的PANNS评分分别与治疗前比较 ,均有显著减少 (P <0 .0 5或P <0 .0 1)。奎硫平与氯氮平有效率分别为 88.4 %和83.3% ,两者治疗计量范围分别为 375～ 6 0 0和 30 0～ 4 75mg·d-1。TESS量表评定奎硫平组的不良反应明显小于氯氮平组。结论 :奎硫平治疗精神分裂症的起效时间与疗效与氯氮平相当 ,不良反应明显小于氯氮平。

AIM: To compare the efficacy and safety between quetiapine and clozapine. METHODS: There were 85 patients with first on-set schizophrenia in this study,43 patients treated with quetiapine 425± 56 mg·d -1 and 42 patients treated with clozapine 350± 73 mg·d -1 . The study lasted for 8 wk. The Positive and Negative Symptom Scale (PANSS) and Treatment Emergent Symptom Scale (TESS) were used to evaluate therapeutic and side effects. RESULTS: The PANSS scores in both groups decreased significantly after treatment with those two drugs(P< 0.05 or P< 0.01 ). The rates of improvement were similar in quetiapine group and in clozapine group ( 88.4 % vs 83.8 %). The efficient dosages ranged from 375 to 600 mg·d -1 for quetiapine and from 300 to 475 mg·d -1 for clozapine. TESS showed quetiapine had fewer side effects than clozapine. CONCLUSION: Quetiapine has similar efficacy and the time before effect to clozapine in the treatment of schizophrenic with fewer side effects than clozapine.