Kang Seung-Gul, Cho Seo-Eun, Na Kyoung-Sae, Pae Chi-Un, Cho Seong-Jin
Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Department of Psychiatry, Bucheon St. Mary's Hospital, Bucheon, Korea.
Clin Psychopharmacol Neurosci. 2021 Feb 28;19(1):117-124. doi: 10.9758/cpn.2021.19.1.117.
The response to antipsychotics in patients with schizophrenia is still unsatisfactory. Therefore, augmentation with other antipsychotics is common in clinical situations. The purpose of this study was to evaluate the improvement of psychiatric symptoms and side effects after amisulpride add-on therapy.
Forty patients with schizophrenia or schizoaffective disorder without treatment response to second-generation antipsychotics were included in this study. Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS) and the Korean version of Calgary Depression Scale for Schizophrenia (CDSS) at baseline, 4 weeks, and 8 weeks after the addition of amisulpride.
Among the 29 subjects who completed the 8-week study, 34.5% were responders according to PANSS total score. At week 8, the mean positive ( < 0.001), negative ( < 0.001), general ( < 0.001), and total ( < 0.001) PANSS scores and CDSS scores ( = 0.002) showed significant improvement compared to baseline. There was no increase in extrapyramidal side effects according to Simpson Angus Scale ( = 0.379) and Barnes Akathisia Rating Scale ( = 0.070) and no weight gain ( = 0.308) after the add-on treatment.
The addition of amisulpride for schizophrenia patients without therapeutic response to second-generation antipsychotics is considered an effective and safe treatment. This study's results suggested that augmentation of second-generation antipsychotics with amisulpride could be a useful option for patients with schizophrenia unresponsive to second-generation antipsychotics. Further studies investigating the efficacy of amisulpride add-on therapy using placebo control are necessary to confirm these results.
精神分裂症患者对抗精神病药物的反应仍不尽人意。因此，在临床中用其他抗精神病药物进行增效治疗很常见。本研究的目的是评估阿立哌唑增效治疗后精神症状的改善情况及副作用。
本研究纳入了40例对第二代抗精神病药物无治疗反应的精神分裂症或分裂情感性障碍患者。在添加阿立哌唑治疗的基线、4周和8周时，使用阳性和阴性症状量表（PANSS）以及韩国版精神分裂症卡尔加里抑郁量表（CDSS）评估精神病症状。
在完成8周研究的29名受试者中，根据PANSS总分，34.5%为反应者。在第8周时，与基线相比，平均阳性（<0.001）、阴性（<0.001）、一般（<0.001）和总分（<0.001）PANSS评分以及CDSS评分（=0.002）均有显著改善。根据辛普森·安格斯量表（=0.379）和巴恩斯静坐不能评定量表（=0.070），锥体外系副作用没有增加，增效治疗后体重也没有增加（=0.308）。
对于对第二代抗精神病药物无治疗反应的精神分裂症患者，添加阿立哌唑被认为是一种有效且安全的治疗方法。本研究结果表明，用阿立哌唑增强第二代抗精神病药物对第二代抗精神病药物无反应的精神分裂症患者可能是一种有用的选择。有必要进行进一步的研究，使用安慰剂对照来研究阿立哌唑增效治疗的疗效，以证实这些结果。
