Bark Nigel, Lawson Nicholas, Trigoboff Eileen, Varadi Rodica, Grace Jeffery, Olympia Josie, Sindhu Nighat, Watson Tom, El-Defrawi Mohamed, Roy Punyabrata
Clin Schizophr Relat Psychoses. 2018 Summer;12(2):77-85. doi: 10.3371/CSRP.BALA123015.
So far, demographic variables have not consistently been found to predict clinical response to antipsychotics. This study examines some differences in response to ziprasidone, which has been shown to be effective, with a better metabolic side effect profile, but was little used in New York State Hospitals. The aim was to study state hospital patients switched to ziprasidone. The results led to questions about different responses in different groups. Subjects from state hospitals who needed a change of antipsychotic participated in this open-label, 8-week trial of up to 240-mg ziprasidone. Analyses included comparisons of the very different results from two sites. Of the 36 study subjects, 12 terminated early. The 17 outpatients from Buffalo, who were older and on lower doses of antipsychotics pre-study, improved significantly. The 19 inpatients from the Bronx, overall younger and on higher pre-study doses, barely changed. Improvements in PANSS total score were significantly associated with older age, greater baseline severity, and lower doses of antipsychotics pre-study. The subjects improved on metabolic parameters. The results suggest that ziprasidone may be just as effective as previous antipsychotics taken by these severely mentally ill patients, and with fewer metabolic side effects. Note: The study described here includes a dosage of ziprasidone that has not been approved by the U.S. Food and Drug Administration (FDA). The FDA has approved daily doses of ziprasidone no greater than 100 mg PO bid.
到目前为止，尚未一致发现人口统计学变量能够预测抗精神病药物的临床疗效。本研究考察了对齐拉西酮反应的一些差异，齐拉西酮已被证明是有效的，且代谢副作用较小，但在纽约州医院中很少使用。目的是研究转用齐拉西酮的州立医院患者情况。结果引发了关于不同组间不同反应的疑问。来自州立医院且需要更换抗精神病药物的受试者参与了这项开放标签、为期8周、最高剂量达240毫克齐拉西酮的试验。分析包括对两个地点截然不同的结果进行比较。在36名研究受试者中，12人提前终止试验。来自布法罗的17名门诊患者，年龄较大且研究前抗精神病药物剂量较低，病情有显著改善。来自布朗克斯的19名住院患者，总体较年轻且研究前剂量较高，几乎没有变化。阳性和阴性症状量表（PANSS）总分的改善与年龄较大、基线严重程度较高以及研究前抗精神病药物剂量较低显著相关。受试者的代谢参数有所改善。结果表明，齐拉西酮对这些重症精神病患者可能与之前服用的抗精神病药物同样有效，且代谢副作用较少。注意：此处描述的研究中使用的齐拉西酮剂量尚未获得美国食品药品监督管理局（FDA）的批准。FDA批准的齐拉西酮每日口服剂量不超过100毫克，每日两次。
