Fleischhacker W W
Department of Biological Psychiatry, Innsbruck University Clinics, Austria.
J Clin Psychiatry. 1999;60 Suppl 12:30-4.
Clinical studies with clozapine have clearly demonstrated its superior efficacy over that of conventional antipsychotics in treatment-resistant schizophrenic patients. In comparative trials with these drugs, considerably more patients respond to treatment with clozapine than to conventional antipsychotic medication. Recently, new antipsychotics, such as olanzapine, quetiapine, risperidone, sertindole, and zotepine, have been introduced, but extensive data on their effects in treatment-resistant patients are not yet available. Published studies have drawn criticism in terms of inappropriate titration schedules, nonequivalent dosing between treatment groups, short treatment duration, and inadequate sample sizes. Further research will be needed to determine whether novel antipsychotics may substitute for clozapine in the future or whether clozapine will retain its unique role in the management of patients suffering from difficult-to-treat schizophrenic disorders.
氯氮平的临床研究已清楚表明,在难治性精神分裂症患者的治疗中,它比传统抗精神病药物具有更高的疗效。在与这些药物的对比试验中,对氯氮平治疗有反应的患者比接受传统抗精神病药物治疗的患者多得多。最近,新型抗精神病药物如奥氮平、喹硫平、利培酮、舍吲哚和佐替平已被引入,但关于它们在难治性患者中疗效的广泛数据尚未可得。已发表的研究在滴定方案不当、治疗组间剂量不等效、治疗持续时间短和样本量不足等方面受到批评。未来还需要进一步研究以确定新型抗精神病药物是否可能替代氯氮平,或者氯氮平是否将在难治性精神分裂症疾病的管理中保留其独特作用。