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一项利培酮治疗青少年和青年成年轻度厌食症的双盲、安慰剂对照研究:一项初步研究。

A double-blind, placebo-controlled study of risperidone for the treatment of adolescents and young adults with anorexia nervosa: a pilot study.

机构信息

University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO 80045, USA.

出版信息

J Am Acad Child Adolesc Psychiatry. 2011 Sep;50(9):915-24. doi: 10.1016/j.jaac.2011.06.009. Epub 2011 Aug 5.

Abstract

OBJECTIVE

The purpose of this double-blind, placebo-controlled exploratory pilot study was to evaluate the safety and efficacy of risperidone for the treatment of anorexia nervosa.

METHOD

Forty female subjects 12 to 21 years of age (mean, 16 years) with primary anorexia nervosa in an eating disorders program were randomized to receive risperidone (n = 18) or placebo (n = 22). Subjects completed the Eating Disorder Inventory 2, Color-A-Person Test, Body Image Software, and Multidimensional Anxiety Scale for Children at baseline and regular intervals. Weight, laboratory values, and electrocardiograms were monitored. Study medication was started at 0.5 mg daily and titrated upward weekly in 0.5-mg increments to a maximum dose of 4 mg until the subject reached a study endpoint.

RESULTS

The mean dose for the risperidone group was 2.5 mg and for the placebo group was 3 mg for a mean duration of 9 weeks. Subjects taking risperidone had a significant decrease on the Eating Disorder Inventory 2 Drive for Thinness subscale over the first 7 weeks (effect size, 0.88; p = .002), but this difference was not sustained to the end of the study (p = .13). The Eating Disorder Inventory 2 Interpersonal Distrust subscale decreased significantly more in subjects taking risperidone (effect size, 0.60; p = .03). Subjects taking risperidone had increased prolactin levels (week 7; p = .001). There were no significant differences between groups at baseline or the end of the study for the other rating scales, change in weight, or laboratory measurements.

CONCLUSIONS

This study does not demonstrate a benefit for the addition of risperidone in adolescents with anorexia nervosa during the weight-restoration phase of care. Clinical trial registration information-A Double-Blind, Placebo-Controlled Study of Risperidone for the Treatment of Anorexia Nervosa, http://www.clinicaltrials.gov, NCT00140426.

摘要

目的

本双盲、安慰剂对照探索性试验旨在评估利培酮治疗厌食症的安全性和疗效。

方法

40 名年龄在 12 至 21 岁(平均 16 岁)的厌食症进食障碍项目的女性患者被随机分为利培酮组(n=18)或安慰剂组(n=22)。在基线和定期检查时,患者完成了饮食障碍量表 2、颜色人物测试、身体形象软件和多维焦虑量表儿童版。监测体重、实验室值和心电图。研究药物从 0.5mg/天开始,每周增加 0.5mg,最大剂量为 4mg,直到患者达到研究终点。

结果

利培酮组的平均剂量为 2.5mg,安慰剂组为 3mg,平均持续时间为 9 周。服用利培酮的患者在第 1 至 7 周时,饮食障碍量表 2 中“消瘦欲望”子量表显著下降(效应量为 0.88,p=0.002),但这种差异在研究结束时并未持续(p=0.13)。服用利培酮的患者,饮食障碍量表 2 中“人际不信任”子量表显著下降(效应量为 0.60,p=0.03)。服用利培酮的患者催乳素水平升高(第 7 周,p=0.001)。在基线和研究结束时,两组在其他评定量表、体重变化或实验室检查方面均无显著差异。

结论

在厌食症患者体重恢复阶段,该研究并未证明添加利培酮对患者有益。临床试验注册信息——利培酮治疗厌食症的双盲、安慰剂对照研究,http://www.clinicaltrials.gov,NCT00140426。

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