Perez Victor, Cañas Fernando, Tafalla Monica
Department of Psychiatry, Hospital de la Sta Creu i Sant Pau, Barcelona CIBERSAM, Spain.
Int Clin Psychopharmacol. 2008 May;23(3):138-49. doi: 10.1097/YIC.0b013e3282f47c44.
This multicentre, observational, prospective, nonrandomized study compared the effectiveness and tolerability of quetiapine and risperidone in the acute and long-term treatment of schizophrenia in a clinical setting. Patients admitted to an acute unit with schizophrenia, schizophreniform or schizoaffective disorder (DSM-IV), who were prescribed quetiapine or risperidone (3 : 1 ratio) within the first week of treatment, according to the physician's usual practice, were recruited. In total, 492 patients (quetiapine: 367; risperidone: 125) were followed up at weeks 1 and 2, discharge and 6 and 12 months thereafter. Mean doses at 12 months were: quetiapine 718.5 mg/day and risperidone 7.0 mg/day. Efficacy measures (Brief Psychiatric Rating Scale, Clinical Global Impression Severity of Illness and Improvement) indicated similar results for both agents. No difference was found in rehospitalization rate with either drug. In terms of tolerability, orthostatic hypotension was more frequent with quetiapine, but extrapyramidal symptoms and male sexual dysfunction were more frequent with risperidone. In conclusion, quetiapine and risperidone had comparable effectiveness, but there were differences between treatments in their side effect profile.
这项多中心、观察性、前瞻性、非随机研究比较了喹硫平和利培酮在临床环境中对精神分裂症急性和长期治疗的有效性和耐受性。根据医生的常规做法,招募了入住急性病房、患有精神分裂症、精神分裂症样或分裂情感性障碍(DSM-IV)且在治疗第一周内被处方喹硫平或利培酮(比例为3:1)的患者。共有492名患者(喹硫平组:367名;利培酮组:125名)在第1周和第2周、出院时以及此后的6个月和12个月进行了随访。12个月时的平均剂量为:喹硫平718.5毫克/天,利培酮7.0毫克/天。疗效指标(简明精神病评定量表、临床总体印象疾病严重程度和改善情况)显示两种药物的结果相似。两种药物的再住院率均未发现差异。在耐受性方面,喹硫平引起的体位性低血压更为常见,但利培酮引起的锥体外系症状和男性性功能障碍更为常见。总之,喹硫平和利培酮具有相当的有效性,但在副作用方面存在差异。