Harada T, Otsuki S, Sato M, Wake A, Fujiwara Y, Kashihara K, Fukuda K
Pharmacopsychiatry. 1987 Feb;20(1 Spec No):47-51. doi: 10.1055/s-2007-1017129.
We reported the results of a survey of patients who suffered from schizophrenia with predominate hallucinatory and delusional states, and who had been unresponsive to a variety of antipsychotics like haloperidol but responded more favorably to zotepine. In 10 of the 22 zotepine-responsive patients in this study, there was marked improvement with zotepine. Considering the results from previous drug treatment, the phenothiazines (especially levomepromazine) surpassed the butyrophenones in efficacy, suggesting that zotepine might resemble levomepromazine clinically. After administration of zotepine, cenesthesic hallucination, behavior caused by hallucination, egorrhoe, affective symptoms, and catatonic symptoms were markedly improved. However, insight into disease and negative symptoms were minimally improved after administration of zotepine. Zotepine was effective in the refractory psychoses due to its potent action on the delusional dynamics, in spite of producing little marked improvement in such main symptoms as hallucination and delusion. The authors speculate that zotepine's potent activity at serotonin-1 receptors may lead to a beneficial effect in refractory psychoses, just as in the case of its antimanic effect.
我们报告了一项针对患有以幻觉和妄想状态为主的精神分裂症患者的调查结果，这些患者对多种抗精神病药物（如氟哌啶醇）无反应，但对佐替平反应更佳。在本研究中22名对佐替平有反应的患者中，有10名使用佐替平后有显著改善。考虑到先前药物治疗的结果，吩噻嗪类药物（尤其是左美丙嗪）在疗效上超过了丁酰苯类药物，这表明佐替平在临床上可能类似于左美丙嗪。服用佐替平后，本体幻觉、由幻觉引起的行为、秽语症、情感症状和紧张症症状均有显著改善。然而，服用佐替平后，对疾病的洞察力和阴性症状改善甚微。尽管佐替平在幻觉和妄想等主要症状上几乎没有明显改善，但由于其对妄想动态有强大作用，因此对难治性精神病有效。作者推测，佐替平对5-羟色胺-1受体的强大活性可能导致对难治性精神病产生有益效果，就如同其抗躁狂作用一样。
