Lee Kyoung-Uk, Jeon Yang-Whan, Lee Hae-Kook, Jun Tae-Youn
Department of Psychiatry, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Korea.
Hum Psychopharmacol. 2009 Aug;24(6):447-52. doi: 10.1002/hup.1047.
To investigate the efficacy and safety of quetiapine for depressive symptoms in patients with schizophrenia.
Thirty-nine patients fulfilling DSM-IV-TR diagnostic criteria for schizophrenia and had depressive symptoms were studied in a prospective 6-week open-label design using quetiapine monotherapy. The brief psychiatric rating scale (BPRS), 17-item Hamilton depression rating scale (HAMD-17), Simpson-Angus rating scale, and the Barnes Akathisia rating scale (BARS) were used to assess patients at baseline, week 1, 2, 4, and 6.
Thirty patients (76.9%) completed this study. The dose of quetiapine at endpoint was 583 (+/-235 SD) mg/day. Treatment with Quetiapine was associated with significantly reduced depressive symptoms (HAMD-17 total score and BPRS depression/anxiety subscale) from the first week of treatment. Changes of mean score from baseline to endpoint were 7.8 +/- 6.2 for HAMD-17 total score and 3.4 +/- 3.6 for BPRS depression/anxiety subscale (LOCF, n = 39, p < 0.001). Quetiapine was well tolerated, with minimal extrapyramidal symptoms and non-significant increase in body weight (mean increase of 0.8 kg).
While the interpretation of findings from the open-label design of this study warrants appropriate caution, the results suggest that quetiapine may be an effective and tolerable treatment for depression in patients with schizophrenia.
探讨喹硫平治疗精神分裂症患者抑郁症状的疗效和安全性。
对39例符合DSM-IV-TR精神分裂症诊断标准且有抑郁症状的患者进行前瞻性6周开放标签设计的喹硫平单药治疗研究。使用简明精神病评定量表(BPRS)、17项汉密尔顿抑郁评定量表(HAMD-17)、辛普森-安格斯评定量表和巴恩斯静坐不能评定量表(BARS)在基线、第1、2、4和6周对患者进行评估。
30例患者(76.9%)完成了本研究。终点时喹硫平剂量为583(±235标准差)mg/天。从治疗第一周起,喹硫平治疗使抑郁症状(HAMD-17总分和BPRS抑郁/焦虑子量表)显著减轻。HAMD-17总分从基线到终点的平均得分变化为7.8±6.2,BPRS抑郁/焦虑子量表为3.4±3.6(末次观察结转,n = 39,p < 0.001)。喹硫平耐受性良好,锥体外系症状轻微,体重无显著增加(平均增加0.8 kg)。
虽然本研究开放标签设计的结果解释需要适当谨慎,但结果表明喹硫平可能是治疗精神分裂症患者抑郁的有效且耐受性良好的药物。