Pharmacy Department, Whitchurch Hospital, Cardiff, UK.
Int J Psychiatry Clin Pract. 2008;12(4):243-6. doi: 10.1080/13651500801993241.
Aim. The efficacy of aripiprazole has been demonstrated in randomised controlled trials, but due to inclusion and exclusion criteria, these may not be representative of clinical practice. The aim of this naturalistic study was to investigate patients from an acute mental health trust who received aripiprazole, using treatment discontinuation as a primary outcome measure. Method. All patients with schizophrenia or schizoaffective disorder who had received aripiprazole were identified from pharmacy records, and data collected by retrospective case note review. Results. Seventy subjects were included in the study. A total of 28 (40%, n=70) patients remained on aripiprazole monotherapy at 6 months. The most common reason for discontinuation was lack of effect, seen in 29 patients; only 12 patients discontinued due to adverse effects. Thirty-five percent of the subjects had previously been treated with clozapine, although this did not appear to influence outcome. Conclusion. Despite limitations of the naturalistic methodology used in this study, it appears that aripiprazole is relatively well tolerated, and effective in clinical practice. The 40% continuation rate seen with aripiprazole is comparable to that seen with risperidone, quetiapine, and perphenazine in the CATIE study at 6 months.
目的。阿立哌唑的疗效已在随机对照试验中得到证实，但由于纳入和排除标准，这些试验可能无法代表临床实践。本自然主义研究的目的是调查来自急性心理健康信托机构的接受阿立哌唑治疗的患者，以治疗中断为主要结局指标。
方法。从药房记录中确定所有接受阿立哌唑治疗的精神分裂症或分裂情感障碍患者，并通过回顾性病历审查收集数据。
结果。本研究共纳入 70 例患者。共有 28 名（40%，n=70）患者在 6 个月时仍接受阿立哌唑单药治疗。停药的最常见原因是缺乏疗效，29 名患者出现这种情况；仅 12 名患者因不良反应而停药。35%的受试者之前曾接受氯氮平治疗，但这似乎并未影响结果。
结论。尽管本研究采用的自然主义方法存在局限性，但阿立哌唑在临床实践中似乎相对耐受良好且有效。在 CATIE 研究中，6 个月时阿立哌唑的 40%持续率与利培酮、喹硫平、奋乃静相似。
