Bartkó György
Jahn Ferenc Dél-pesti Kórház, I. Pszichiátriai és Pszichiátriai Rehabilitációs Osztály.
Neuropsychopharmacol Hung. 2007 Dec;9(4):189-95.
This article reviews the published clinical data on schizophrenic patients managed with the new formulation of quetiapine, the once-daily extended release quetiapine fumarate (quetiapine XR). Quetiapine XR has been developed to reduce the frequency of quetiapine dosing by introducing once-daily administration and to simplify the treatment initiation schedule. Quetiapine XR (400 to 800 mg/day) was effective versus placebo across a broad range of symptom domains in acute schizophrenia and was as well tolerated as the immediate release (IR) formulation. Rapid dose escalation of quetiapine XR (300 mg on day 1,600 mg on day 2, and 800 mg on day 3) was also well tolerated, with a therapeutically effective dose reached by day 2. Clinically stable patients with schizophrenia receiving quetiapine IR (400-800 mg/day) can be switched to an equivalent once-daily dose of quetiapine XR (400-800 mg/day once-daily) without clinical deterioration or compromise in tolerability. Evidence from a clinical trial has shown that patients with schizophrenia who had a history of unsatisfactory treatment (tolerability or efficacy) on typical or atypical antipsychotic experienced improved efficacy and clinical benefit when switched to quetiapine XR. Once-daily quetiapine XR (400-800 mg/nap) was effective compared with placebo in preventing relapse in patients with clinically stable schizophrenia, and was well tolerated during long-term use. Patients could be switched from their ongoing antipsychotic to quetiapine XR within 4 days without compromising efficacy, enabling a dose of 600 mg/day and 800 mg/day to be reached by Day 2 and Day 3 respectively. This new, once-daily formulation of quetiapine offers psychiatrists and patients valuable new treatment options for the short and long-term treatment of schizophrenia.
本文回顾了已发表的关于使用喹硫平新剂型——每日一次的富马酸喹硫平缓释片（quetiapine XR）治疗精神分裂症患者的临床数据。研发喹硫平XR的目的是通过采用每日一次给药来减少喹硫平的给药频率，并简化治疗起始方案。在急性精神分裂症的广泛症状领域中，喹硫平XR（400至800毫克/天）与安慰剂相比有效，并且耐受性与速释（IR）剂型相同。喹硫平XR的快速剂量递增（第1天300毫克，第2天600毫克，第3天800毫克）耐受性也良好，到第2天即可达到治疗有效剂量。接受喹硫平IR（400 - 800毫克/天）治疗的临床稳定的精神分裂症患者可以换用等效的每日一次剂量的喹硫平XR（每日一次400 - 800毫克），而不会出现临床病情恶化或耐受性降低的情况。一项临床试验的证据表明，既往使用典型或非典型抗精神病药物治疗效果不佳（耐受性或疗效方面）的精神分裂症患者换用喹硫平XR后疗效改善，临床获益。每日一次的喹硫平XR（400 - 800毫克/天）与安慰剂相比，在预防临床稳定的精神分裂症患者复发方面有效，且长期使用耐受性良好。患者可以在4天内从正在使用的抗精神病药物换用喹硫平XR，而不影响疗效，分别在第2天和第3天达到600毫克/天和800毫克/天的剂量。这种新的每日一次的喹硫平剂型为精神科医生和患者提供了用于精神分裂症短期和长期治疗的有价值的新治疗选择。
