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溴隐亭治疗抗精神病药物引起的高催乳素血症的疗效:为期 8 周的随机、单盲、安慰剂对照、多中心研究。

Effect of bromocriptine on antipsychotic drug-induced hyperprolactinemia: eight-week randomized, single-blind, placebo-controlled, multicenter study.

机构信息

Department of Psychiatry, Korea University, College of Medicine, Seoul, Korea.

出版信息

Psychiatry Clin Neurosci. 2010 Feb;64(1):19-27. doi: 10.1111/j.1440-1819.2009.02032.x. Epub 2009 Nov 24.

Abstract

AIM

The objective of the present study was to assess the efficacy and safety of bromocriptine treatment for patients with antipsychotic-drug-induced hyperprolactinemia in clinical practice.

METHODS

This was an 8-week randomized, single-blind, placebo-controlled, multicenter study. Sixty female schizophrenia patients were enrolled and were randomly assigned to one of four treatment groups: bromocriptine 2.5 mg/day, 5 mg/day, 10 mg/day, and placebo. Serum levels of prolactin, estradiol (E2), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were evaluated on three occasions (baseline, and 4 and 8 weeks after commencement of the treatment paradigm). Extrapyramidal symptoms (EPS) and clinical symptoms were assessed using the Simpson-Angus scale and the Positive and Negative Syndrome Scale (PANSS), respectively.

RESULTS

Of the 60 subjects who were enrolled, 48 completed the study (n = 14, 13, 11, and 10 in the bromocriptine 2.5 mg/day, 5 mg/day, and 10 mg/day, and placebo groups, respectively). Four patients in the 10-mg/day group, two in the 5-mg/day group, and one in the placebo group resumed menses during the study. The mean level of prolactin significantly decreased from baseline to week 4, and then plateaued, showing no significant change for the remaining 4 weeks of the study. No significant changes in LH, FSH, or E2 levels were observed throughout the 8-week study period, either within or between groups.

CONCLUSION

Administration of bromocriptine is a safe method for treating antipsychotic-drug-induced hyperprolactinemia without exacerbating either psychotic symptoms or EPS.

摘要

目的

本研究旨在评估溴隐亭治疗抗精神病药物引起的高催乳素血症的疗效和安全性。

方法

这是一项为期 8 周的随机、单盲、安慰剂对照、多中心研究。共纳入 60 例女性精神分裂症患者,随机分为 4 组,分别接受溴隐亭 2.5mg/d、5mg/d、10mg/d 和安慰剂治疗。在 3 个时间点(基线、治疗开始后 4 周和 8 周)评估血清催乳素、雌二醇(E2)、黄体生成素(LH)和卵泡刺激素(FSH)水平。使用 Simpson-Angus 量表和阳性和阴性症状量表(PANSS)分别评估锥体外系症状(EPS)和临床症状。

结果

60 例入组患者中,48 例完成了研究(2.5mg/d、5mg/d、10mg/d 和安慰剂组分别有 14、13、11 和 10 例)。10mg/d 组有 4 例、5mg/d 组有 2 例和安慰剂组有 1 例患者在研究期间恢复了月经。催乳素水平从基线到第 4 周显著下降,然后趋于稳定,在研究的其余 4 周内没有显著变化。在整个 8 周的研究期间,LH、FSH 或 E2 水平在组内和组间均无显著变化。

结论

溴隐亭治疗抗精神病药物引起的高催乳素血症安全有效,不会加重精神症状或 EPS。

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