Lin Huang-Chi, Chong Mian-Yoon, Lee Yu, Yeh Wei-Chiang, Lin Pao-Yen
Department of Psychiatry, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Chang Gung Med J. 2009 Jul-Aug;32(4):409-16.
A sudden change in antipsychotics in the pharmacotherapy of schizophrenia might worsen the clinical condition or induce a relapse of psychotic symptoms. This study reports on shifting from other antipsychotics to aripiprazole during the course of treatment, with further analysis of factors related to a successful switch.
An observational study was conducted. Study subjects included 45 patients with schizophrenia whose medication was changed from other antipsychotics to aripiprazole. The reasons for the change, course of illness, and types and dosage of antipsychotics previously used were collected. The clinical severity before and 12 weeks after switching or at termination were assessed using the Clinical Global Impression-Severity scale.
The majority (71.1%) of the study subjects changed antipsychotics because of adverse effects from previous medications. About 70% successfully completed the switch. Patients who had been taking second-generation antipsychotics(SGAs), had less clinically severe disease, or had a shorter course of illness were able to make a smoother transition to aripiprazole. Reported adverse events related to the transition were mild and infrequent.
Not all antipsychotics can be successfully switched to aripiprazole, a novel antipsychotic. Apart from clinical factors, a successful change of antipsychotics also depends on the complexity and the pharmacological properties, as well as the duration of administration of previous antipsychotics.
在精神分裂症药物治疗中，抗精神病药物的突然更换可能会使临床病情恶化或导致精神病症状复发。本研究报告了在治疗过程中从其他抗精神病药物转换为阿立哌唑的情况，并进一步分析了与成功换药相关的因素。
进行了一项观察性研究。研究对象包括45例精神分裂症患者，他们的用药从其他抗精神病药物换成了阿立哌唑。收集了换药原因、病程以及先前使用的抗精神病药物的类型和剂量。使用临床总体印象-严重程度量表评估换药前、换药后12周或治疗结束时的临床严重程度。
大多数（71.1%）研究对象因先前药物的不良反应而更换抗精神病药物。约70%的患者成功完成了换药。服用第二代抗精神病药物（SGA）、临床病情较轻或病程较短的患者能够更顺利地过渡到阿立哌唑。报告的与换药相关的不良事件轻微且不常见。
并非所有抗精神病药物都能成功转换为新型抗精神病药物阿立哌唑。除临床因素外，抗精神病药物的成功更换还取决于先前抗精神病药物的复杂性、药理特性以及用药时长。
