齐拉西酮与氯氮平治疗同时患有精神分裂症和大麻使用障碍的双重诊断（DD）患者：一项随机研究。
Ziprasidone versus clozapine in the treatment of dually diagnosed (DD) patients with schizophrenia and cannabis use disorders: a randomized study.
作者信息
Schnell Thomas, Koethe Dagmar, Krasnianski Anna, Gairing Stefanie, Schnell Knut, Daumann Jörg, Gouzoulis-Mayfrank Euphrosyne
机构信息
Department of Psychiatry and Psychotherapy, University Hospital of Cologne, Cologne, Germany.
出版信息
Am J Addict. 2014 May-Jun;23(3):308-12. doi: 10.1111/j.1521-0391.2014.12126.x. Epub 2014 Mar 15.
BACKGROUND AND OBJECTIVES
Clozapine is considered to be particularly effective in the treatment of dually diagnosed (DD) patients with psychosis and substance use disorders. However, its use is restricted by potentially severe side effects. The aim of the present pilot study was to compare the effects of clozapine with the newer second generation antipsychotic (SGA) ziprasidone in DD-patients.
METHODS
Thirty (n = 30) patients with schizophrenia and cannabis abuse/dependence were randomized to ziprasidone or clozapine and were followed up for up to 12 months.
RESULTS
Cannabis use was reduced in both groups during follow-up. Clozapine treatment was associated with less positive symptoms of schizophrenia, more side effects and poorer compliance with treatment.
CONCLUSIONS
Results from this small pilot RCT suggest beneficial effects of both clozapine and ziprasidone in the treatment of cannabis use disorders in psychotic patients. Larger-scale RCTs are needed in order to assess advantages and disadvantages of the different SGAs in dually diagnosed populations.
背景与目的
氯氮平被认为在治疗同时患有精神病和物质使用障碍的双重诊断（DD）患者方面特别有效。然而，其使用受到潜在严重副作用的限制。本试点研究的目的是比较氯氮平与新型第二代抗精神病药物（SGA）齐拉西酮对双重诊断患者的疗效。
方法
30名患有精神分裂症和大麻滥用/依赖的患者被随机分为齐拉西酮组或氯氮平组，并随访长达12个月。
结果
随访期间两组的大麻使用量均有所减少。氯氮平治疗与精神分裂症的阳性症状较少、副作用较多以及治疗依从性较差有关。
结论
这项小型试点随机对照试验的结果表明，氯氮平和齐拉西酮在治疗精神病患者大麻使用障碍方面均有有益效果。需要进行更大规模的随机对照试验，以评估不同第二代抗精神病药物在双重诊断人群中的优缺点。
Zotero 插件