Takeuchi Takashi, Furuta Ko, Hirasawa Toshiyuki, Masaki Hidekazu, Yukizane Tomoaki, Atsuta Hidenori, Nishikawa Toru
Section of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
Psychiatry Clin Neurosci. 2007 Feb;61(1):67-70. doi: 10.1111/j.1440-1819.2007.01612.x.
Perospirone is a recently developed atypical antipsychotic with potent serotonin 5-HT2 and dopamine D2 antagonist activity. Other atypical antipsychotics including risperidone, quetiapine and olanzapine have been widely used for treatment, not only for schizophrenia symptoms but also for delirium, because of their low potential to induce extrapyramidal disturbances. In the present study the effectiveness and safety of perospirone in patients with delirium are described. Thirty-eight patients with DSM-IV delirium were given open-label perospirone. To evaluate the usefulness of perospirone, scores from 13 severity items of the Delirium Rating Scale-Revised-98 were assessed. Data were gathered from October 2003 to September 2004. Perospirone was effective in 86.8% (33/38) of patients, and the effect appeared within several days (5.1 +/- 4.9 days). The initial dose was 6.5 +/- 3.7 mg/day and maximum dose of perospirone was 10.0 +/- 5.3 mg/day. There were no serious adverse effects. However, increased fatigue (15.2%), sleepiness (6.1%), akathisia (3.0%) and a decline in blood pressure (3.0%) were observed. It is proposed that perospirone may be another safe and effective atypical antipsychotic drug for the treatment of delirium symptoms in hospitalized patients. This is a preliminary open trial, and further randomized double-blind placebo-controlled tests are needed.
哌罗匹隆是一种最近研发的非典型抗精神病药物，具有强效的5-羟色胺5-HT2和多巴胺D2拮抗剂活性。包括利培酮、喹硫平和奥氮平在内的其他非典型抗精神病药物已被广泛用于治疗，不仅用于治疗精神分裂症症状，还用于治疗谵妄，因为它们诱发锥体外系障碍的可能性较低。在本研究中，描述了哌罗匹隆治疗谵妄患者的有效性和安全性。38例符合DSM-IV标准的谵妄患者接受了开放标签的哌罗匹隆治疗。为评估哌罗匹隆的有效性，采用谵妄评定量表修订版98中13项严重程度指标进行评分。数据收集时间为2003年10月至2004年9月。86.8%（33/38）的患者使用哌罗匹隆有效，且疗效在数天内（5.1±4.9天）显现。初始剂量为6.5±3.7mg/天，哌罗匹隆最大剂量为10.0±5.3mg/天。未出现严重不良反应。然而，观察到疲劳感增加（15.2%）、嗜睡（6.1%）、静坐不能（3.0%）和血压下降（3.0%）。有人提出，哌罗匹隆可能是另一种安全有效的非典型抗精神病药物，可用于治疗住院患者的谵妄症状。这是一项初步的开放试验，需要进一步进行随机双盲安慰剂对照试验。
