Üçok Alp, Saka Meram Can, Bilici Mustafa
Alp Üçok, M.D., Professor of Psychiatry, Istanbul University, Istanbul Faculty of Medicine , Istanbul , Turkey.
Nord J Psychiatry. 2015 Aug;69(6):426-32. doi: 10.3109/08039488.2014.996252. Epub 2014 Dec 31.
Response to antipsychotic treatment is better in the early stages of schizophrenia.
The primary objective of this non-randomized, single-arm, multicenter clinical trial was to explore the response to treatment and safety of a flexible dose of paliperidone (mean = 6.42 mg/day) in patients with recent onset schizophrenia (< 3 years after the first episode/hospitalization).
Severity of clinical symptoms was evaluated by the Positive and Negative Syndrome Scale (PANSS), functioning was assessed using the Global Assessment of Functioning (GAF) scale and the Personal and Social Performance Scale (PSP).
In a total of 85 patients enrolled, 80 patients were eligible. Total PSP score at baseline (50.2 ± 11.6) increased at all visits. Total PSP score was 65.4 ± 12.1 at month 12 (P < 0.001). GAF scores were significantly higher at all visits compared with baseline (P = 0.001). It was 62.4 ± 12.5 with an increase of 42.9% at month 12 (P < 0.001). PANSS Positive and Negative subscales and General psychopathology subscale scores showed significant reductions beginning with month 3 and were 11.9 ± 3.8 (29.3%; P < 0.001), 13.7 ± 5.6 (27.3% P < 0.001) and 27.8 ± 7.1 (23.2%; P < 0.001) at month 12, respectively. Twelve patients (14.3%) had a serious adverse event. The most common adverse events were insomnia (17.9%), nausea (8.3%), akathisia (4.8%), anxiety (4.8%) and depression (4.8%). Body weight values at the end of the study were significantly higher compared with baseline.
The present study demonstrates that flexible dose of paliperidone resulted in a significant improvement in functioning and reduction in symptoms in patients with recent onset schizophrenia.
精神分裂症早期对抗精神病药物治疗的反应更好。
这项非随机、单臂、多中心临床试验的主要目的是探讨灵活剂量的帕利哌酮(平均 = 6.42毫克/天)对近期发病精神分裂症患者(首次发作/住院后<3年)的治疗反应和安全性。
通过阳性和阴性症状量表(PANSS)评估临床症状的严重程度,使用功能总体评定量表(GAF)和个人与社会表现量表(PSP)评估功能。
总共纳入85例患者,其中80例符合条件。基线时的PSP总分(50.2±11.6)在所有访视时均升高。第12个月时PSP总分是65.4±12.1(P<0.001)。与基线相比,所有访视时GAF评分均显著更高(P = 0.001)。第12个月时为62.4±12.5,升高了42.9%(P<0.001)。PANSS阳性、阴性分量表和一般精神病理分量表评分从第3个月开始显著降低,第12个月时分别为11.9±3.8(29.3%;P<0.001)、13.7±5.6(27.3%,P<0.001)和27.8±7.1(23.2%;P<0.001)。12例患者(14.3%)发生严重不良事件。最常见的不良事件是失眠(17.9%)、恶心(8.3%)、静坐不能(4.8%)、焦虑(4.8%)和抑郁(4.8%)。研究结束时的体重值与基线相比显著更高。
本研究表明,灵活剂量的帕利哌酮可使近期发病精神分裂症患者的功能显著改善,症状减轻。