Pintor L, Fuente E, Bailles E, Matrai S
Psychiatry Department, Neurosciences Institute, Hospital Clínico de Barcelona, C/Roselló 140, 08036 Barcelona, Spain.
Eur Psychiatry. 2009 Oct;24(7):450-5. doi: 10.1016/j.eurpsy.2009.05.013. Epub 2009 Aug 19.
To evaluate the efficacy and safety of amisulpride in medical inpatients who present with delirium.
Open label prospective study with 7-day follow-up. Forty hospital inpatients with delirium were recruited, seven of whom died and two of whom refused medication. The average dose of amisulpride for delirium treatment was 200-300 mg/day. Daily assessments were performed with Delirium Rating Scale (DRS), Positive Subscale of the Positive and Negative Syndrome Scale (PANSS-P), Mini Mental State Examination (MMSE), Neurological Subscale of the UKU side effect rating scale. Variance analysis was performed through repeated measurements, with the general linear model with paired comparisons and Bonferroni correction for each measured variable.
Patients showed significant improvement on the DRS from the first day of treatment DRS = 17.55 until day 7 DRS = 7.26 (F = 92.485; p < 0.001), psychotic symptoms improved from first day PANSS-P = 18.26 to last day PANSS-P = 9.35 (F = 144.83; p < 0.001). Cognitive status showed a significant improvement from day 2 MMSE = 18.71 until day 7 MMSE = 24.06 (F = 96.56; p < 0.001), and the neurological subscale of the UKU side effect rating scale showed a significant improvement the last day with respect to baseline pretreatment level (F = 7.539; p = 0.01).
These results suggest a good response to amisulpride in the acute phase of delirium, although further randomized controlled studies must be performed.
评估氨磺必利对伴有谵妄的内科住院患者的疗效和安全性。
进行为期7天随访的开放标签前瞻性研究。招募了40名患有谵妄的住院患者,其中7人死亡,2人拒绝用药。治疗谵妄的氨磺必利平均剂量为200 - 300毫克/天。每天使用谵妄评定量表(DRS)、阳性和阴性症状量表的阳性分量表(PANSS - P)、简易精神状态检查表(MMSE)、UKU副作用评定量表的神经学分量表进行评估。通过重复测量进行方差分析,对每个测量变量采用具有配对比较和Bonferroni校正的一般线性模型。
从治疗第1天DRS = 17.55到第7天DRS = 7.26,患者的DRS有显著改善(F = 92.485;p < 0.001),精神症状从第1天PANSS - P = 18.26改善到最后一天PANSS - P = 9.35(F = 144.83;p < 0.001)。认知状态从第2天MMSE = 18.71到第7天MMSE = 24.06有显著改善(F = 96.56;p < 0.001),并且UKU副作用评定量表的神经学分量表在最后一天相对于基线预处理水平有显著改善(F = 7.539;p = 0.01)。
这些结果表明氨磺必利在谵妄急性期有良好反应,尽管必须进行进一步的随机对照研究。