Barbee J G, Mancuso D M, Freed C R, Todorov A A
Department of Psychiatry, School of Medicine, Louisiana State University, New Orleans 70112.
Am J Psychiatry. 1992 Apr;149(4):506-10. doi: 10.1176/ajp.149.4.506.
While neuroleptics remain the mainstay of drug intervention in the emergency management of psychosis, a variety of agents have received study as alternatives or adjuncts to these drugs in an attempt to improve the safety and efficacy of acute treatment. The purposes of this study were to investigate the efficacy and safety of alprazolam as a neuroleptic adjunct for schizophrenic patients in psychotic relapse and to clarify the effects of combination treatment on specific aspects of the psychotic process.
Twenty-eight acutely psychotic patients with schizophrenia who were admitted to an emergency psychiatric service were randomly assigned to treatment with either haloperidol and alprazolam or haloperidol with placebo under double-blind conditions. Drug administration lasted 72 hours.
Both groups improved significantly. The combination-treated group required significantly less medication and had 56% fewer dystonic reactions. The addition of alprazolam was most effective for symptoms of excitement and uncooperativeness, particularly in the initial hours of treatment.
The combination of alprazolam and haloperidol seems to be the most effective for agitated patients, particularly in the first 48 hours of treatment. It may also result in fewer dystonic reactions.
虽然抗精神病药物仍然是精神病紧急处理中药物干预的主要手段，但为了提高急性治疗的安全性和有效性，人们对多种药物作为这些药物的替代或辅助药物进行了研究。本研究的目的是调查阿普唑仑作为抗精神病药物辅助用药对精神分裂症复发患者的疗效和安全性，并阐明联合治疗对精神病过程特定方面的影响。
28名入住急诊精神科的急性精神病性精神分裂症患者在双盲条件下被随机分配接受氟哌啶醇与阿普唑仑联合治疗或氟哌啶醇与安慰剂治疗。药物治疗持续72小时。
两组均有显著改善。联合治疗组所需药物显著减少，肌张力障碍反应减少56%。添加阿普唑仑对兴奋和不合作症状最有效，尤其是在治疗的最初几个小时。
阿普唑仑与氟哌啶醇联合使用似乎对激越患者最有效，尤其是在治疗的前48小时。它还可能减少肌张力障碍反应。
