Athens University Medical School, 1st Psychiatry Department, Eginition Hospital, Athens, Greece.
Int J Geriatr Psychiatry. 2009 May;24(5):518-22. doi: 10.1002/gps.2146.
Although schizophrenia affects all age groups, late or very-late-onset schizophrenia-like psychosis has not been well studied and various treatment issues remain unresolved. The objective of the present study was to evaluate the efficacy and safety of amisulpride monotherapy in a diagnostically homogeneous group of elderly patients without cognitive impairment suffering from very-late-onset schizophrenia.
Twenty-six patients of mean age 76.2 +/- 5.8 years, fulfilling both the recent consensus criteria for very late-onset schizophrenia-like psychosis and the DSM-IV-TR criteria for schizophrenia, were assessed by the Brief Psychiatric Rating Scale, the Clinical Global Impression Scale and the Positive and Negative Syndrome Scale at baseline and five weeks following amisulpride (50-200 mg/day) administration; also, the presence of abnormal movements was evaluated with the Simpson-Angus Scale, the Barnes Akathisia Scale, and the Abnormal Involuntary Movement Scale.
A highly significant (p < 0.001) improvement on all measures of psychotic symptomatology was observed in all patients. Amisulpride was very well tolerated by the patients and no clinically significant adverse effects were observed. Scores on all abnormal movement scales did not differ significantly prior to and after amisulpride treatment.
Preliminary results indicate that amisulpride appears to be an efficacious and safe atypical antipsychotic for the treatment of very-late-onset schizophrenia-like psychosis.
尽管精神分裂症影响所有年龄段,但对于晚发性或极晚发性类似精神分裂症的精神病,研究并不充分,各种治疗问题仍未解决。本研究的目的是评估氨磺必利单药治疗无认知障碍的老年极晚发性精神分裂症患者的疗效和安全性。
26 名平均年龄为 76.2 +/- 5.8 岁的患者,均符合极晚发性类似精神分裂症精神病的最新共识标准和精神分裂症的 DSM-IV-TR 标准,使用简明精神病评定量表、临床总体印象量表和阳性和阴性症状量表在基线和氨磺必利(50-200mg/天)治疗 5 周后进行评估;同时,使用 Simpson-Angus 量表、Barnes 静坐不能量表和异常不自主运动量表评估异常运动的存在。
所有患者的精神病症状量表评分均有显著改善(p < 0.001)。氨磺必利非常耐受患者,未观察到临床显著的不良反应。氨磺必利治疗前后所有异常运动量表评分无显著差异。
初步结果表明,氨磺必利似乎是一种有效且安全的非典型抗精神病药,可用于治疗极晚发性类似精神分裂症的精神病。