Centre de Recherche Fernand Seguin, Hôpital L.-H. Lafontaine, Université de Montréal, Montréal, Québec, Canada.
Prog Neuropsychopharmacol Biol Psychiatry. 2010 Aug 16;34(6):997-1000. doi: 10.1016/j.pnpbp.2010.05.010. Epub 2010 May 12.
In clinical psychopharmacology, the optimal method of switching from treatment A to treatment B with regard to efficacy and tolerability is an important area of study. We investigated the effects on efficacy and tolerability of switching patients from conventional antipsychotics to ziprasidone. This was a 6-week open-label, randomized study of 54 patients with persistent schizophrenia or schizoaffective disorder. Patients received ziprasidone 40 mg BID for 2 days, with titration up to 80 mg BID thereafter. The switch from conventional antipsychotics to ziprasidone was achieved using one of three discrete schedules: (1) abrupt discontinuation of conventional antipsychotics on day 1; (2) fast taper-50% of conventional antipsychotic dosage on days 1 through 7, followed by discontinuation and (3) slow taper-100% of conventional antipsychotic dosage on days 1 and 2, followed by 50% on days 3 through 7, then discontinuation. We found some evidence that the slow-taper strategy was associated with greater reductions in BPRS total scores early in the study compared to the other two strategies. However, these differences did not remain significant at endpoint, suggesting that there was no overall difference between the strategies.
在临床精神药理学中，从治疗 A 切换到治疗 B 的最佳方法是疗效和耐受性，这是一个重要的研究领域。我们研究了将患者从传统抗精神病药物转换为齐拉西酮对疗效和耐受性的影响。这是一项为期 6 周的开放性、随机研究，共有 54 例持续性精神分裂症或分裂情感障碍患者参与。患者接受齐拉西酮 40mg，bid，持续 2 天，此后滴定至 80mg，bid。从传统抗精神病药物转换为齐拉西酮采用三种不同方案之一：（1）第 1 天突然停用传统抗精神病药物；（2）第 1 天至第 7 天快速减量，常规抗精神病药物剂量减少 50%，然后停药；（3）第 1 天和第 2 天逐渐减量，常规抗精神病药物剂量减少 100%，然后第 3 天至第 7 天减少 50%，然后停药。我们发现一些证据表明，与其他两种策略相比，在研究早期，缓慢减量策略与 BPRS 总分的更大降低相关。然而，这些差异在终点时不再显著，这表明这些策略之间没有总体差异。
