Rabey Jose M, Prokhorov Tatiana, Miniovitz Ala, Dobronevsky Eugenia, Klein Colin
Department of Neurology, Assaf Harofeh Medical Center, Zerifin, Israel, affiliated to the Sackler School of Medicine, Tel Aviv University, Israel.
Mov Disord. 2007 Feb 15;22(3):313-8. doi: 10.1002/mds.21116.
This double-blind randomized study examined the effect of quetiapine (QTP) on drug-induced psychosis (DIP) in Parkinson's disease (PD). Conventional antipsychotic drugs are associated with adverse extrapyramidal effects. QTP is a new atypical antipsychotic drug used in the treatment of psychosis in PD. A total of 58 consecutive psychotic PD patients (mean age, 75 +/- 8.3 years; mean disease duration, 10.5 +/- 6.4 years; 29 with dementia) were randomly assigned to 2 groups: 30 were treated with QTP (mean dose, 119.2 +/- 56.4 mg) and 28 received placebo for 3 months. The motor part of the Unified Parkinson's Disease Rating Scale, the Brief Psychiatric Rating Scale, the Mini-Mental State Examination, the Hamilton Rating Scale for Depression, the Epworth Sleepiness Score, and the Clinical Global Impression Scale were administered before and during the study. No significant difference was found between the groups in all parameters. There were 32 PD patients (55%) completed the 3-month study (15 [26%] QTP and 17 [29%] placebo). Treatment was interrupted in 15 patients in the QTP and 11 in the placebo groups. This double-blind study did not show a beneficial effect of QTP for the treatment of DIP in PD. The high rate of withdrawal probably influenced the results. Larger double-blind studies are required.
这项双盲随机研究考察了喹硫平（QTP）对帕金森病（PD）药物性精神病（DIP）的影响。传统抗精神病药物会引发不良锥体外系反应。QTP是一种用于治疗PD精神病的新型非典型抗精神病药物。共有58例连续性精神病性PD患者（平均年龄75±8.3岁；平均病程10.5±6.4年；29例患有痴呆）被随机分为两组：30例接受QTP治疗（平均剂量119.2±56.4毫克），28例接受安慰剂治疗，为期3个月。在研究前及研究期间使用统一帕金森病评定量表的运动部分、简明精神病评定量表、简易精神状态检查表、汉密尔顿抑郁评定量表、爱泼华嗜睡量表及临床总体印象量表进行评估。两组在所有参数上均未发现显著差异。有32例PD患者（55%）完成了为期3个月的研究（15例[26%]使用QTP，17例[29%]使用安慰剂）。QTP组有15例患者、安慰剂组有11例患者中断了治疗。这项双盲研究未显示QTP对治疗PD的DIP有有益效果。高退出率可能影响了结果。需要开展更大规模的双盲研究。
