氨磺必利与奥氮平治疗阴性症状和认知障碍的疗效：一项开放标签临床研究。
Efficacy of amisulpride and olanzapine for negative symptoms and cognitive impairments: An open-label clinical study.
作者信息
Kumar Subodh, Chaudhury Suprakash
机构信息
All India Institute of Medical Sciences, New Delhi, India.
Department of Psychiatry, Pravara Institute of Medical Sciences, Deemed University, Rural Medical College and Hospital, Loni, Maharashtra, India.
出版信息
Ind Psychiatry J. 2014 Jan;23(1):27-35. doi: 10.4103/0972-6748.144953.
BACKGROUND
Negative symptoms and diminished cognitive ability are also considered as core features of schizophrenia. There are many studies in which negative symptoms and cognitive impairments are individually treated with atypical antipsychotic in comparison with either a placebo or a typical antipsychotic. There is paucity of studies comparing the efficacy of olanzapine and amisulpride on improvement of negative symptoms and cognitive impairments.
AIM
To examine the effectiveness of amisulpride and olanzapine in treatment of negative symptoms and cognitive impairments in schizophrenia.
MATERIALS AND METHODS
Total 40 adult inpatients diagnosed as schizophrenia fulfilling inclusion/exclusion criteria were included in the study with their informed consent. These patients were recruited consecutively to one of the two drug regimen group, i.e. tab Amisulpride (100-300 mg/day) and tab Olanzapine (10-20 mg). Patients were evaluated on day 0 and day 60 with various rating scales like Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), Schizophrenia Cognition Rating Scale (SCoRS), Brief Psychiatric Rating Scale (BPRS), Calgary Depression Scale for Schizophrenia (CDSS), and three different scales to measure drug side effects.
RESULTS
The mean SANS score in amisulpride and olanzapine group at day 0 and day 60 were 83.89 (±12.67) and 21.00 (±11.82) and 84.40 (±13.22) and 26.75 (±12.41), respectively. The mean rank of SCoRS global in amisulpride and olanzapine group at day 0 and day 60 were 4.78 (±1.13) and 2.78 (±0.63) and 4.85 (±1.18) and 3.30 (±1.12), respectively. The percentage improvement in SANS, SAPS, SCoRS interviewer, and SCoRS global in amisulpride group are 74.96%, 13.36%, 54.14%, and 42.00%, respectively. Similarly in olanzapine group percentage improvement in SANS, SAPS, SCoRS interviewer, and SCoRS global are 68.30%, 30.28%, 35.22%, and 31.95%, respectively. There is significant improvement in SANS, SCoRS, SAS, BPRS, and PANSS (Insight) in both amisulpride and olanzapine groups at the two time points. However, there is no significant difference between amisulpride and olanzapine group of patients.
CONCLUSION
Both amisulpride and olanzapine group patients showed significant improvement in negative and cognitive symptoms from baseline to endpoint, but there was no significant difference between amisulpride and olanzapine group of patients.
背景
阴性症状和认知能力减退也被视为精神分裂症的核心特征。有许多研究将非典型抗精神病药物与安慰剂或典型抗精神病药物进行对比，单独治疗阴性症状和认知障碍。比较奥氮平和氨磺必利对改善阴性症状和认知障碍疗效的研究较少。
目的
探讨氨磺必利和奥氮平治疗精神分裂症阴性症状和认知障碍的有效性。
材料与方法
共有40例符合纳入/排除标准、诊断为精神分裂症的成年住院患者在获得知情同意后纳入本研究。这些患者被连续招募到两种药物治疗方案组之一，即氨磺必利片（100 - 300毫克/天）和奥氮平片（10 - 20毫克）。在第0天和第60天使用各种评定量表对患者进行评估，如阴性症状评定量表（SANS）、阳性症状评定量表（SAPS）、精神分裂症认知评定量表（SCoRS）、简明精神病评定量表（BPRS）、精神分裂症卡尔加里抑郁量表（CDSS），以及三种不同的量表来测量药物副作用。
结果
氨磺必利组和奥氮平组在第0天和第60天的平均SANS评分分别为83.89（±12.67）和21.00（±11.82），以及84.40（±13.22）和26.75（±12.41）。氨磺必利组和奥氮平组在第0天和第60天的SCoRS总体平均秩次分别为4.78（±1.13）和2.78（±0.63），以及4.85（±1.18）和3.30（±1.12）。氨磺必利组SANS、SAPS、SCoRS访谈者评分和SCoRS总体评分的改善百分比分别为74.96%、13.36%、54.14%和42.00%。同样，奥氮平组SANS、SAPS、SCoRS访谈者评分和SCoRS总体评分的改善百分比分别为68.30%、30.28%、35.22%和31.95%。在两个时间点，氨磺必利组和奥氮平组的SANS、SCoRS、SAS、BPRS和PANSS（洞察力）均有显著改善。然而，两组患者之间没有显著差异。
结论
氨磺必利组和奥氮平组患者从基线到终点在阴性和认知症状方面均有显著改善，但两组患者之间没有显著差异。
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