Pae Chi-Un, Serretti Alessandro, Chiesa Alberto, Mandelli Laura, Lee Changuk, Lee Chul, Kim Jungjin, De Ronchi Diana, Paik In-Ho
Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, South Korea.
Eur Neuropsychopharmacol. 2009 Aug;19(8):562-70. doi: 10.1016/j.euroneuro.2009.04.002. Epub 2009 May 12.
The aim of the present work was to investigate possible differences in terms of efficacy and tolerability between different switching options to aripiprazole. 77 subjects were randomly assigned to (1) administration of aripiprazole (10 mg) with simultaneous discontinuation of current antipsychotic; (2) administration of aripiprazole (10 mg) and tapering off current antipsychotic over 4 weeks with half dose after the first 2 weeks; (3) administration of aripiprazole (10 mg) and tapering off current antipsychotic over 6 weeks with half dose after the first 2 weeks. Efficacy assessments included CGI-S, CGI-I, BPRS and SANS. Safety assessments included SAS, BAS and AIMS. Severity of symptoms significantly decreased from baseline over the 12 weeks of treatment. Patients switched to aripiprazole with immediate discontinuation of the previous antipsychotic showed an increase of symptoms' severity at week 1. However, severity of side effects did not overall change significantly during the 12-weeks follow-up. Previous treatment's tapering off strategy for switching patients to aripiprazole could be preferable as compared to abrupt discontinuation, in order to prevent early worsening of symptoms and premature discontinuation of treatment, though this results has to be considered with caution given the limitations of the study.
本研究的目的是调查不同的阿立哌唑转换方案在疗效和耐受性方面可能存在的差异。77名受试者被随机分配到：（1）服用阿立哌唑（10毫克）并同时停用当前抗精神病药物；（2）服用阿立哌唑（10毫克），并在4周内逐渐减少当前抗精神病药物剂量，在前2周后给予半量；（3）服用阿立哌唑（10毫克），并在6周内逐渐减少当前抗精神病药物剂量，在前2周后给予半量。疗效评估包括临床总体印象量表严重程度（CGI-S）、临床总体印象量表改善程度（CGI-I）、简明精神病评定量表（BPRS）和阴性症状评定量表（SANS）。安全性评估包括副反应量表（SAS）、巴恩斯静坐不能评定量表（BAS）和异常不自主运动量表（AIMS）。在12周的治疗期间，症状严重程度从基线水平显著下降。直接停用先前抗精神病药物而转换为阿立哌唑的患者在第1周时症状严重程度增加。然而，在12周的随访期间，副作用的严重程度总体上没有显著变化。与突然停药相比，在将患者转换为阿立哌唑时逐渐减少先前治疗药物的策略可能更可取，以防止症状早期恶化和治疗过早中断，不过鉴于该研究的局限性，这一结果必须谨慎看待。
