非典型抗精神病药治疗精神分裂症的临床应用评价Clinical Evaluation of Atypical Antipsychotics in the Treatment of Schizophrenia
黄继忠,张明园
摘要(Abstract):
目的:系统论述非典型抗精神病药治疗精神分裂症临床研究和应用的进展,评价其临床疗效和安全性。方法:通过互联网查阅Medline、Pubmed、Ovid、Science Direct、Proquest及国内外相关专业杂志所公开发表的研究报道进行综合评价和分析。结果与结论:非典型抗精神病药近10年来的临床应用研究进展迅速,除氯氮平外,大多数新型非典型抗精神病药如利培酮、奥氮平、喹硫平、齐拉西酮及阿立哌唑等已成为精神分裂症各种症状维度、不同病期和复发预防的一线临床选择,特别是在不良反应方面克服了经典抗精神病药和氯氮平的诸多严重缺点,同时,各种临床研究结果已被多项应用循证医学方法的系统研究所证实。
关键词(KeyWords): 非典型抗精神病药;经典抗精神病药;精神分裂症;临床试验;临床评价;循证精神病学;锥体外系症状
基金项目(Foundation):
作者(Author): 黄继忠,张明园
DOI: 10.14009/j.issn.1672-2124.2005.02.003
参考文献(References):
- [1]KinonBJ,LiebermanJA.Mechanisms of action of atypicalantipsychotic drugs: a critical analysis[J].Psychopharma cology,1996,124:2.
- [2]AnderssonC,ChakosM,MailmanR, et al.Emerging rolesfor novel antipsychotic medications in the treatment of schizo phreniz[J].PsychiatrClin northAm,1998,21:151.
- [3]LeysenJE,JanssenPMF,SchotteA, et al.Interaction of an tipsychotic drugs with neurotransmitter receptor sites in vitroand in vivo in relation to pharmacological and clinical effects:role of5HT2 receptors[J].Psychopharmacology,1993,112:S40.
- [4]KaneJM,HonigfeldG,SingerJ, et al.Clozapine for thetreatment-resistant schizophrenic.A double-blind compari son with chlorpromazine[J].ArchGenPsychiatry,1988,45:789.
- [5]MeltzerHY,McGurkSR.The effect of clozapine, risperi done, and olanzapine on cognitive function in schizophrenia[J].SchizophrBull,1999,25:233.
- [6]RosenheckR,CramerJ,XuW, et al.A comparison of cloz apine and haloperidol in hospitalized patients with refractoryschizophrenia[J].N EnglJ Med,1997,337:809.
- [7]HaggS,SpigsetO,BateA, et al.Myocarditis related toclozapine treatment[J].J ClinPsychopharmacol,2001,21:382.
- [8]BeasleyCM,TollefsonG,TranP, et al.Olanzapine versusplacebo and haloperidol[J].Neuropsychopharmacology,1996,14:111.
- [9]TollefsonGD,BeasleyCM,TranPV, et al.Olanzapine ver sus haloperidol in the treatment of schizophrenia and schizoaf fective and schizophreniform disorders:results of an internation al collaborative trial[J].AmJ Psychiatry,1997,154:457.
- [10]PurdonSE,JonesBDW,StipE, et al.Neuropsychologicalchange in earlyphase schizophrenia over twelve months of treat ment with olanzapine, risperidone, or haloperidol.TheCana dian collaboration group for research in schizophrenia[J].ArchGenPsychiatry,2000,57:249.
- [11]LindenmayerJP,VolavkaJ,LiebermanJ, et al.Olanzapinefor schizophrenia refractory to typical and atypical antipsychot ics: an open-label, prospective trial[J].J ClinPsychophar macol,2001,21:448.
- [12]ConleyRR,MahmoudR.A randomized double-blind studyof risperidone and olanzapine in the treatment of schizophreniaor schizoaffective disorde[J].AmJ Psychiatry,2001,158:765.
- [13]TranPV,HamiltonSH,KuntzAJ, et al.Double- blindcomparison of olanzapine versus risperidone in the treatment ofschizophrenia and other psychotic disorders[J].J ClinPsy chopharmacol,1997,17:407.
- [14]PerryPJ,LundBC,SangerT, et al.Olanzapine plasma con centrations and clinical response: acute phase results of thenorthAmerican olanzapine trial[J].J ClinPsychopharmacol,2001,21:14.
- [15]LiebzeitKA,MarkowitzJS,CalryCF.New onset diabetes andatypical antipsychotics[J].EurNeuropsychopharmacol,2001,11:25.
- [16]PurdonSE,MallaA,LabelleA, et al.Neuropsychologicalchange in patients with schizophrenia after treatment with que tiapine or haloperidol[J].J PsychiatryNeurosci,2001,26:137.
- [17]CopolovDl,LinkCG,KowalcykB.A multicentre, double-blind, randomized comparison of quetiapine and haloperidol inschizophrenia[J].PsycholMed,2000,30:95.
- [18]EmsleyRA,RaniwallaJ,BaileyPJ, et al.A comparison ofthe effects of quetiapine(‘seroquel’) and haloperidol inschizophrenic patients with a history of and a demonstrated,partial response to conventional antipsychotic treatment[J].IntClinPsychopharmacol,2000,15:121.
- [19]EmsleyRA, theRisperidoneWorkingGroup.Risperidone inthe reatment of first-episode psychotic patients: a double-blind multi-center study[J].SchizophrBull,1999,25:721.
- [20]KipalaLC,GoodKP,HonerWG.Extrapyramidal signs andclinical symptoms in first- episode schizophrenia:response tolow-dose risperidone[J].J ClinPsychopharmacol,1997,17:308.
- [21]LaneHY,ChiuWC,ChouJCY, et al.Risperidone in acute ly exacerbated schizophrenia:dosing strategies and plasma lev els[J].J ClinPsychiatry,2000,61:209.
- [22]CsernanskyJG,MahmoudR,BrennerR.A comparison ofrisperidone and haloperidol for the prevention of relapse in pa tients with schizophrenia[J].N EnglJ Med,2002,346:16.
- [23]MarkianosM,HatzimanolisJ,LykourasL.Neuroendocrineresponsivities of the pituitary dopamine system in male schizo phrenic patients during treatment with clozapine, olanzapine,risperidone, sulpiride, or haloperidol[J].EurArchPsychiatryClinNeurosci,2001,251:141.
- [24]KeckP Jr,BuffensteinA,FergusonJ, et al.Ziprasidone40and20 mg day in the acute exacerbation of schizophrenia andschizoaffective disorder: a4- week placebo controlled trial[J].Psychopharmacology,1998,140:173.
- [25]GoffDC,PoseverT,HerzL, et al.An exploratory haloperi dol-controlled dose finding study of ziprasidone in hospitalizedpatients with schizophrenia or schizoaffective disorde[J].JClinPsychopharmacol,1998,18:296.
- [26]PezawasL,QuinerS,MoertlD, et al.Efficacy, cardiacsafety and tolerability of sertindole:a drug surveillance[J].IntClinPsychopharmacol,2000,15:207.
- [27]VanKammenDP,McEvoyJP,TargumSD, et al.A random ized, controlled, dose-ranging trial of sertindole in patientswith schizophrenia[J].Psychopharmacology,1996,124:168.
- [28]ZimbroffDL,KaneJM,TammingaCA, et al.Controlled,dose-response study of sertindole and haloperidol in the treat ment of schizophrenia[J].AmJ Psychiatry,1997,154:782.
- [29]PeuskensJ,BechP,MollerHJ, et al.Amisulpride vs. ris peridone in the treatment of acute exacerbations of schizophre nia[J].PsychiatryRes,1999,88(2):107.
- [30]HwangTJ,LinSK,LinHN.Efficacy and safety of zotepinefor the treatment ofTaiwanese schizophrenic patients:a double-blind comparison with haloperidol[J].J FormosMedAssoc,2001,100:811.
- [31]PetrieJL,SahaAR,McEvoyJP.Acute and long-term effi cacy and safety of aripiprazole: a new atypical antipsychotic[J].SchizophrRes,1998,29:155.
- [32]PotkinSG,SahaAR,KujawaMJ, et al.Aripiprazole, an an tipsychotic with a novel mechanism of action, and risperidonevs placebo in patients with schizophrenia and schizoaffectivedisorder[J].ArchGenPsychiatry,2003,60:681.
- [33]PigottTA. theAripiprazoleStudyGroup.Aripiprazle for theprevention of relapse in stabilized patients with chronic schizo phrenia:a placebo- controlled26-week study[J].J ClinPsychiatry,2003,64:1048.
- [34]McQuadeR,CarsonW,SahaA, et al.Aripiprazole for long-term maintenance treatment of schizophrenia[J].EuropeanNeuropsychopharmacology,2002,12:S288.
- [35]VolavkaJ,CzoborP,SheitmanB, et al.Clozapine, olanzap ine, risperidone, and haloperidol in the treatment of patientswith chronic schizophrenia and schizoaffective disorder[J].AmJ Psychiatry,2002,159:255.
- [36]DavisJM,ChenN,GlickID.A meta-analysis of the effica cy of second-generation antipsychotics[J].ArchGenPsychi atry,2003,60:553.
- [37]LeuchtS,PitschelWalzG,AbrahamD, et al.Efficacy andextrapyramidal side-effects of the new antipsychotics olanzap ine, quetiapine, risperidone, and sertindole compared to conv entional antipsychotics and placebo.A meta-analysis of ran domized controlled trials[J].SchizophrRes,1999,35:51.