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一项为期6周的利培酮治疗青少年精神分裂症疗效与安全性的随机、双盲、安慰剂对照研究。

A 6-week, randomized, double-blind, placebo-controlled study of the efficacy and safety of risperidone in adolescents with schizophrenia.

作者信息

Haas Magali, Unis Alan S, Armenteros Jorge, Copenhaver Margaret D, Quiroz Jorge A, Kushner Stuart F

机构信息

Johnson & Johnson Pharmaceutical Research and Development, Titusville, New Jersey, USA.

出版信息

J Child Adolesc Psychopharmacol. 2009 Dec;19(6):611-21. doi: 10.1089/cap.2008.0144.

Abstract

OBJECTIVE

The aim of this study was to evaluate the efficacy and safety of two dose ranges of risperidone in adolescents with schizophrenia.

METHODS

In a 6-week, randomized, double-blind, placebo-controlled study, adolescents aged 13-17 years with acute exacerbation of schizophrenia were randomized to placebo, flexible doses of risperidone 1-3 mg/day, or risperidone 4-6 mg/day. Assessments included the Positive and Negative Syndrome Scale (PANSS), clinical response (> or =20% reduction in PANSS total score), adverse event (AE) monitoring, and extrapyramidal symptom (EPS) scale ratings.

RESULTS

A total of 160 subjects received placebo (n = 54), risperidone 1-3 mg/day (n = 55), or risperidone 4-6 mg/day (n = 51). Significant improvements occurred in both risperidone groups versus placebo (p < 0.001) in PANSS total change scores (placebo, -8.9 [16.1]; risperidone 1-3 mg, -21.3 [19.6]; risperidone 4-6 mg, -21.2 [18.3]) and clinical response rates (35%, 65%, 72%, respectively). Overall AE rates were more common in risperidone groups (75% and 76%) versus placebo (54%). Risperidone 4-6 mg/day had a higher incidence of extrapyramidal disorder, dizziness, and hypertonia than risperidone 1-3 mg. No prolactin-related AEs occurred. Overall EPS severity was low.

CONCLUSIONS

Risperidone 1-3 mg/day and 4-6 mg/day were well tolerated and effective in adolescents experiencing acute episodes of schizophrenia. The benefit-risk profile suggests that a dose of 1-3 mg/day might be optimal for this population.

摘要

目的

本研究旨在评估两种剂量范围的利培酮对青少年精神分裂症患者的疗效和安全性。

方法

在一项为期6周的随机、双盲、安慰剂对照研究中,将13至17岁精神分裂症急性加重期的青少年随机分为安慰剂组、灵活剂量的利培酮1 - 3毫克/天组或利培酮4 - 6毫克/天组。评估包括阳性和阴性症状量表(PANSS)、临床反应(PANSS总分降低≥20%)、不良事件(AE)监测以及锥体外系症状(EPS)量表评分。

结果

共有160名受试者接受了安慰剂(n = 54)、利培酮1 - 3毫克/天(n = 55)或利培酮4 - 6毫克/天(n = 51)治疗。与安慰剂组相比,两个利培酮组在PANSS总分变化得分(安慰剂组,-8.9 [16.1];利培酮1 - 3毫克组,-21.3 [19.6];利培酮4 - 6毫克组,-21.2 [18.3])和临床反应率(分别为35%、65%、72%)方面均有显著改善。总体不良事件发生率在利培酮组(75%和76%)高于安慰剂组(54%)。利培酮4 - 6毫克/天组的锥体外系疾病、头晕和张力亢进的发生率高于利培酮1 - 3毫克组。未发生与催乳素相关的不良事件。总体EPS严重程度较低。

结论

利培酮1 - 3毫克/天和4 - 6毫克/天对经历精神分裂症急性发作的青少年耐受性良好且有效。效益风险分析表明,1 - 3毫克/天的剂量可能对该人群最为适宜。

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