Lewander T, Westerbergh S E, Morrison D
Astra Research Centre, Södertälje, Sweden.
Acta Psychiatr Scand Suppl. 1990;358:92-8. doi: 10.1111/j.1600-0447.1990.tb05297.x.
Nine double-blind studies comparing remoxipride to haloperidol in the treatment of acute schizophrenia formed the basis of this analysis. All studies followed a basic protocol with the main assessments performed regularly during the 4-6 week trial period according to the same methodology, thus allowing the data to be pooled. The results showed that remoxipride in a daily dose of 150-600 mg had a therapeutic effect comparable to that of haloperidol (5-45 mg/day), both on positive and negative symptoms. There was a clear advantage for remoxipride over haloperidol with regard to adverse events/symptoms, particularly extrapyramidal symptoms, but also drowsiness/somnolence and tiredness/fatigue. Anticholinergic drugs were used consistently less frequently as concomitant medication to alleviate extrapyramidal symptoms in the remoxipride group: the use of sedatives/hypnotics was approximately the same in both groups. Based on these and supportive clinical data, remoxipride seems to have a clinical profile characterized by antipsychotic efficacy in acute schizophrenia, apparently equal to that of haloperidol, and good tolerability in being non-sedative (in terms of drowsiness/somnolence) and with low incidences of extrapyramidal, autonomic, and endocrine symptoms.
九项比较瑞莫必利与氟哌啶醇治疗急性精神分裂症的双盲研究构成了本分析的基础。所有研究均遵循基本方案,在4 - 6周的试验期内按照相同方法定期进行主要评估,从而使数据能够汇总。结果表明,每日剂量为150 - 600毫克的瑞莫必利在治疗阳性和阴性症状方面具有与氟哌啶醇(每日5 - 45毫克)相当的治疗效果。在不良事件/症状方面,尤其是锥体外系症状,以及嗜睡/昏睡和疲倦/疲劳方面,瑞莫必利明显优于氟哌啶醇。在瑞莫必利组中,作为缓解锥体外系症状的辅助用药,抗胆碱能药物的使用频率始终较低:两组中镇静剂/催眠药的使用情况大致相同。基于这些以及支持性的临床数据,瑞莫必利似乎具有这样一种临床特征:在急性精神分裂症中具有抗精神病疗效,显然与氟哌啶醇相当,并且具有良好的耐受性,即无镇静作用(就嗜睡/昏睡而言),锥体外系、自主神经和内分泌症状的发生率较低。