利培酮增效治疗对氯氮平部分反应的精神分裂症：一项双盲、安慰剂对照试验
Risperidone augmentation for schizophrenia partially responsive to clozapine: a double-blind, placebo-controlled trial.
作者信息
Freudenreich Oliver, Henderson David C, Walsh Jared P, Culhane Melissa A, Goff Donald C
机构信息
Massachusetts General Hospital Schizophrenia Program, Freedom Trail Clinic, 25 Staniford St., 2nd Floor, Boston, MA 02114, USA.
出版信息
Schizophr Res. 2007 May;92(1-3):90-4. doi: 10.1016/j.schres.2006.12.030. Epub 2007 Feb 23.
RATIONALE
Risperidone augmentation of clozapine in refractory schizophrenia has theoretical but only inconsistent support from clinical trials.
OBJECTIVES
To examine if adding risperidone to stable yet symptomatic schizophrenia outpatients on optimized clozapine monotherapy improves psychopathology.
METHODS
We conducted a double-blind placebo-controlled parallel-group trial of a fixed dose of 4 mg/day risperidone added for 6 weeks in 24 outpatients with schizophrenia.
RESULTS
Subjects who received risperidone showed a non-significant decrease in PANSS total score. The PANSS disorganized thought subscale improved significantly (beta=-3.3079, p=0.047).
CONCLUSIONS
Our trial does not support the routine addition of risperidone to clozapine in refractory schizophrenia patients. However, much larger trials are needed to conclusively settle the question of added efficacy from this combination.
理论依据
在难治性精神分裂症中，使用利培酮增强氯氮平的疗效虽有理论依据，但临床试验的支持并不一致。
目的
探讨在接受优化氯氮平单药治疗且病情稳定但仍有症状的精神分裂症门诊患者中，加用利培酮是否能改善精神病理学症状。
方法
我们进行了一项双盲安慰剂对照平行组试验，对24例精神分裂症门诊患者加用固定剂量4毫克/天的利培酮，持续6周。
结果
接受利培酮治疗的受试者阳性和阴性症状量表（PANSS）总分有非显著性下降。PANSS紊乱思维分量表有显著改善（β=-3.3079，p=0.047）。
结论
我们的试验不支持在难治性精神分裂症患者中常规将利培酮加用至氯氮平治疗中。然而，需要开展规模大得多的试验才能最终解决这种联合用药是否增加疗效的问题。
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