Faludi Gábor
Semmelweis Egyetem, Kútvölgyi Klinikai Tömb, Pszichiátriai Klinikai Csoport, Budapest.
Neuropsychopharmacol Hung. 2005 Mar;7(1):22-7.
Schizophrenia is a major chronic psychiatric disorder associated with significant impairment in psychosocial functioning and reduced quality of life. The major goals of current pharmacotherapy for schizophrenia are to achieve continuous relief from psychotic symptoms, to reduce relapse rates, and to provide maximal patient functioning and improved quality of life. To attain these goals, treatment needs to be effective, safe, and well tolerated. It is now generally accepted that the use of second generation or atypical antipsychotics for schizophrenia represents and advance over conventional antipsychotics. However, therapeutic compliance continues to be a major problems of the maintenance treatment. The long-acting conventional injectable antipsychotics might increase compliance, but they have become unpopular, largely because of the associated adverse events--akathisia, akinesia, and weight gain. Long-acting risperidone is the first atypical antipsychotic to be available in a long-acting formulation, which combines the benefits of risperidone with the advantages of a long-acting injection. It is dosed at 25-50 mg every 2 weeks. Available data on long acting atypical risperidone suggest that it is safe, efficacious and well tolerated. Long acting risperidone initiated during inpatient and outpatient treatment may be an important strategy in improving long-term outcomes among patients with schizophrenia. This article provides practical advice to physicians on he characteristics of patients who would benefit from treatment with long acting atypical antipsychotic agent and offers suggestions on how to initiate treatment.
精神分裂症是一种主要的慢性精神疾病，与心理社会功能的显著损害和生活质量下降有关。目前精神分裂症药物治疗的主要目标是持续缓解精神病症状、降低复发率，并使患者功能最大化和提高生活质量。为实现这些目标，治疗需要有效、安全且耐受性良好。现在人们普遍认为，使用第二代或非典型抗精神病药物治疗精神分裂症比传统抗精神病药物更具优势。然而，治疗依从性仍然是维持治疗的一个主要问题。长效传统注射用抗精神病药物可能会提高依从性，但它们已不再受欢迎，主要是因为相关的不良事件——静坐不能、运动迟缓以及体重增加。长效利培酮是第一种有长效剂型的非典型抗精神病药物，它将利培酮的益处与长效注射的优势结合在一起。每两周给药25 - 50毫克。关于长效非典型利培酮的现有数据表明它安全、有效且耐受性良好。在住院和门诊治疗期间开始使用长效利培酮可能是改善精神分裂症患者长期预后的一项重要策略。本文就哪些患者特征会从长效非典型抗精神病药物治疗中获益向医生提供实用建议，并就如何开始治疗提供建议。
