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硝普钠对精神分裂症患者精神症状及空间工作记忆的影响:一项随机、双盲、安慰剂对照试验。

The effect of sodium nitroprusside on psychotic symptoms and spatial working memory in patients with schizophrenia: a randomized, double-blind, placebo-controlled trial.

作者信息

Stone J M, Morrison P D, Koychev I, Gao F, Reilly T J, Kolanko M, Mohammadinasab A, Kapur S, McGuire P K

机构信息

King's College London, Institute of Psychiatry Psychology and Neuroscience,London,UK.

出版信息

Psychol Med. 2016 Dec;46(16):3443-3450. doi: 10.1017/S0033291716002245. Epub 2016 Sep 22.

DOI:10.1017/S0033291716002245
PMID:27655012
Abstract

BACKGROUND

Sodium nitroprusside (SNP) has been reported to rapidly reduce psychotic symptoms in patients with schizophrenia. This has the potential to revolutionize treatment for schizophrenia. In this study, we tested the hypothesis that SNP leads to a reduction in psychotic symptoms and an improvement in spatial working memory (SWM) performance in patients with schizophrenia.

METHOD

This was a single-centre, randomized, double-blind, placebo-controlled trial performed from 27 August 2014 to 10 February 2016 (clinicaltrials.gov identifier: NCT02176044). Twenty patients with schizophrenia aged 18-60 years with a diagnosis of schizophrenia or schizoaffective disorder were recruited from psychiatric outpatient clinics in the South London and Maudsley NHS Trust, London, UK. Baseline symptoms were measured using the Positive and Negative Syndrome Scale (PANSS) and the 18-item Brief Psychiatric Rating Scale (BPRS-18), and SWM was assessed using the CANTAB computerized test. Participants received either an infusion of SNP (0.5 μg/kg per min for 4 h) or placebo and were re-assessed for symptoms and SWM performance immediately after the infusion, and 4 weeks later.

RESULTS

SNP did not lead to any reduction in psychotic symptoms or improvement in SWM performance compared to placebo.

CONCLUSIONS

Although this study was negative, it is possible that the beneficial effects of SNP may occur in patients with a shorter history of illness, or with more acute exacerbation of symptoms.

摘要

背景

据报道,硝普钠(SNP)可迅速减轻精神分裂症患者的精神病症状。这有可能彻底改变精神分裂症的治疗方法。在本研究中,我们检验了以下假设:SNP可减轻精神分裂症患者的精神病症状,并改善其空间工作记忆(SWM)表现。

方法

这是一项单中心、随机、双盲、安慰剂对照试验,于2014年8月27日至2016年2月10日进行(临床试验.gov标识符:NCT02176044)。从英国伦敦南伦敦和莫兹利国民保健服务信托基金的精神科门诊招募了20名年龄在18至60岁之间、诊断为精神分裂症或分裂情感性障碍的精神分裂症患者。使用阳性和阴性症状量表(PANSS)和18项简明精神病评定量表(BPRS-18)测量基线症状,并使用CANTAB计算机化测试评估SWM。参与者接受SNP输注(0.5μg/kg每分钟,持续4小时)或安慰剂,并在输注后立即以及4周后重新评估症状和SWM表现。

结果

与安慰剂相比,SNP并未导致精神病症状减轻或SWM表现改善。

结论

尽管本研究结果为阴性,但SNP的有益效果可能出现在病程较短或症状急性加重的患者中。

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