Müller Matthias J
Clinic for Psychiatry and Psychotherapy Giessen and Marburg, Vitos Clinical Centre Giessen-Marburg, Academic Teaching Hospital, University of Giessen, Licher Strasse 106, 35392 Giessen, Germany.
Schizophr Res Treatment. 2011;2011:317368. doi: 10.1155/2011/317368. Epub 2011 Oct 27.
Ziprasidone (ZIP) shows a low propensity for metabolic side effects but can prolong QTc time. It is unclear how these features translate into clinical reality. Charts of inpatients with schizophrenia and switched from (ZIP - , n = 27) or to ZIP (ZIP + , n = 24) were reviewed. Clinical data including documented switch reasons were anonymously analyzed. Comorbidity, body mass index (BMI) at admission, illness severity, side effects, illness duration, and length of stay were comparable in both groups. About 2/3 of ZIP+ were women (1/3 of ZIP - , P = 0.035); ZIP+ patients were younger (P = 0.017), had higher BMI values (P = 0.042), and received higher chlorpromazine equivalents before switch (P = 0.004) whereas ZIP doses were comparable (136 versus 141 mg/d). More patients in ZIP- versus ZIP+ were switched because of previous weight gain (P = 0.006) and depression (P = 0.085) whereas single reasons for ZIP- versus ZIP+ were mainly persisting positive symptoms (P = 0.089) and patients' choice (P = 0.10). The results of the naturalistic study corroborate controlled trials.
齐拉西酮（ZIP）产生代谢副作用的倾向较低，但可延长QTc间期。目前尚不清楚这些特征如何转化为临床实际情况。对患有精神分裂症且从齐拉西酮转换（ZIP - ，n = 27）或转换为齐拉西酮（ZIP + ，n = 24）的住院患者病历进行了回顾。对包括记录的转换原因在内的临床数据进行了匿名分析。两组在合并症、入院时体重指数（BMI）、疾病严重程度、副作用、病程和住院时间方面具有可比性。ZIP +组约2/3为女性（ZIP - 组为1/3，P = 0.035）；ZIP +组患者更年轻（P = 0.017），BMI值更高（P = 0.042），在转换前接受的氯丙嗪等效剂量更高（P = 0.004），而齐拉西酮剂量相当（136对141mg/d）。与ZIP +组相比，ZIP -组更多患者因既往体重增加（P = 0.006）和抑郁（P = 0.085）而转换，而ZIP -组与ZIP +组的单一转换原因主要是持续的阳性症状（P = 0.089）和患者选择（P = 0.10）。这项自然主义研究的结果证实了对照试验。
