Schizophrenia Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Acta Psychiatr Scand. 2013 Mar;127(3):217-26. doi: 10.1111/acps.12009. Epub 2012 Sep 4.
This study examined the effects of adjunctive aripiprazole therapy on metabolism in clozapine-treated patients with schizophrenia.
In an 8-week randomized, double-blind, placebo-controlled study, subjects received either aripiprazole (15 mg/day) or placebo. At baseline and week 8, metabolic parameters were assessed by the frequently sampled intravenous glucose tolerance test, nuclear magnetic resonance spectroscopy and whole-body dual-energy X-ray absorptiometry (DXA).
Thirty subjects completed the study (16 in the aripiprazole group and 14 in the placebo group). Glucose effectiveness measured by the frequently sampled intravenous glucose tolerance test improved significantly in the aripiprazole group (0.003 ± 0.006 vs. -0.005 ± 0.007/min, P = 0.010). The aripiprazole group showed significant reductions in both plasma low-density lipoprotein (LDL) levels (-15.1 ± 19.8 vs. 4.4 ± 22.5 mg/dl, P = 0.019) and LDL particle numbers (-376 ± 632 vs. -36 ± 301 nm, P = 0.035). Further, there was a significant reduction in the lean mass (-1125 ± 1620 vs. 607 ± 1578 g, P = 0.011) measured by whole-body DXA scan in the aripiprazole group. All values were expressed as mean ± standard deviation, aripiprazole vs. placebo.
Adjunctive therapy with aripiprazole may have some metabolic benefits in clozapine-treated patients with schizophrenia.
本研究旨在探讨阿立哌唑辅助治疗对氯氮平治疗的精神分裂症患者代谢的影响。
在一项为期 8 周的随机、双盲、安慰剂对照研究中，受试者接受阿立哌唑（15mg/天）或安慰剂治疗。在基线和第 8 周，通过多次静脉葡萄糖耐量试验、磁共振波谱和全身双能 X 射线吸收法（DXA）评估代谢参数。
30 名受试者完成了研究（阿立哌唑组 16 名，安慰剂组 14 名）。多次静脉葡萄糖耐量试验测量的葡萄糖效应在阿立哌唑组显著改善（0.003±0.006 比-0.005±0.007/min，P=0.010）。阿立哌唑组血浆低密度脂蛋白（LDL）水平（-15.1±19.8 比 4.4±22.5mg/dl，P=0.019）和 LDL 颗粒数（-376±632 比-36±301nm，P=0.035）均显著降低。此外，全身 DXA 扫描显示阿立哌唑组的瘦体重（-1125±1620 比 607±1578g，P=0.011）也有显著减少。所有值均以平均值±标准差表示，阿立哌唑与安慰剂相比。
阿立哌唑辅助治疗可能对氯氮平治疗的精神分裂症患者有一些代谢益处。
