Zedkova Iveta, Dudova Iva, Urbanek Tomas, Hrdlicka Michal
Department of Child Psychiatry, Charles University, Prague, Czech Republic.
Neuro Endocrinol Lett. 2011;32(5):667-70.
The aim of our study was to assess the time to 'first improvement' associated with specific atypical (AAP) and typical (TAP) antipsychotic drugs in patients with early-onset schizophrenia and other related psychotic disorders.
This study involved a systematic chart review of all patients receiving routine clinical care in our department, with selected AAPs and TAPs, for schizophrenic psychoses, between 1997 and 2007. During this period, our review identified 296 teenage patients (141 males, 155 females; mean age 16.0 ± 1.5 years). The time to first improvement could be estimated in 258 patients; of these, 195 patients (76%) had been treated with AAPs and 63 patients (24%) with TAPs. We found that most patients were taking risperidone (N = 96), followed by olanzapine (64 patients). Other patient numbers were as follows: ziprasidone (16 patients), quetiapine (12 patients), clozapine (7 patients), haloperidol (15 patients), perphenazine (28 patients), and sulpiride (20 patients).
The mean time to first improvement was 6.9 (± 4.2) days in the AAP group and 5.8 (± 3.5) days in the TAP group; the difference was significant at the trend level (p=0.063). With respect to individual drugs, the mean time to first improvement was 7.1 (± 4.1) days for risperidone, 6.7 (± 4.2) days for olanzapine, 6.5 (± 5.2) days for ziprasidone, 6.1 (± 4.4) days for quetiapine, 7.4 (± 3.0) days for clozapine, 5.2 (± 2.4) days for haloperidol, 5.9 (± 3.8) days for perphenazine, and 6.0 (± 3.9) days for sulpiride. Differences among drugs were not significant (p=0.680).
Analysis revealed a significant group level trend indicating that typical antipsychotic drugs have faster onsets of action than atypical antipsychotic drugs.
我们研究的目的是评估早发性精神分裂症及其他相关精神障碍患者使用特定非典型（AAP）和典型（TAP）抗精神病药物后出现“首次改善”的时间。
本研究对1997年至2007年间在我们科室接受常规临床护理、使用选定的AAP和TAP治疗精神分裂症的所有患者进行了系统的病历回顾。在此期间，我们的回顾确定了296名青少年患者（141名男性，155名女性；平均年龄16.0±1.5岁）。258名患者可估算出首次改善的时间；其中，195名患者（76%）接受了AAP治疗，63名患者（24%）接受了TAP治疗。我们发现大多数患者服用利培酮（N = 96），其次是奥氮平（64名患者）。其他患者人数如下：齐拉西酮（16名患者）、喹硫平（12名患者）、氯氮平（7名患者）、氟哌啶醇（15名患者）、奋乃静（28名患者）和舒必利（20名患者）。
AAP组首次改善的平均时间为6.9（±4.2）天，TAP组为5.8（±3.5）天；在趋势水平上差异显著（p = 0.063）。就个别药物而言，利培酮首次改善的平均时间为7.1（±4.1）天，奥氮平为6.7（±4.2）天，齐拉西酮为6.5（±5.2）天，喹硫平为6.1（±4.4）天，氯氮平为7.4（±3.0）天，氟哌啶醇为5.2（±2.4）天，奋乃静为5.9（±3.8）天，舒必利为6.0（±3.9）天。药物之间的差异不显著（p = 0.680）。
分析显示出显著的组水平趋势，表明典型抗精神病药物的起效速度比非典型抗精神病药物更快。
