Department of Neurology, Okayama Kyokuto Hospital, Okayama, Japan.
Okayama Neurology Clinic, Okayama, Japan.
Neuropsychopharmacol Rep. 2022 Jun;42(2):135-141. doi: 10.1002/npr2.12235. Epub 2022 Feb 28.
To evaluate the effect of aripiprazole on psychosis and motor function in Japanese Parkinson's disease patients.
Patients with Parkinson's disease and hallucinations and/or delusions were enrolled. They were administered aripiprazole 3 mg/day, with dosage increased or reduced as needed. Patients were evaluated using the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression-Severity (CGI-S) scale, and Clinical Global Impression-Improvement scale for psychiatric response; Hoehn & Yahr staging and Unified Parkinson's Disease Rating Scale (UPDRS) part III for motor response; Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB) for cognitive response; and Schwab and England Activities of Daily Living scale for daily activities of patients, before and at 2, 4, and 12 weeks after initiation of open-label aripiprazole administration. This study was registered at the University Hospital Medical Information Network Center (registration number: UMIN000007711).
Nine of the 24 enrolled patients discontinued the study. Among them, eight patients discontinued the trial on account of their worsening parkinsonian symptoms. There were no differences in age, disease duration, disease severity, and MMSE and FAB scores at baseline between patients who continued and discontinued the study. However, in patients who continued aripiprazole administration at 3 mg/day or less significantly improved BPRS, CGI-S scale, and UPDRS parts I and III scores.
Significant improvements in hallucinations and delusions can be expected, although aripiprazole may aggravate parkinsonism in Parkinson's disease patients. Low-dose use of aripiprazole may be useful for managing Parkinson's disease patients with psychosis, but only with close observation of extrapyramidal symptoms.
评估阿立哌唑对日本帕金森病患者精神病和运动功能的影响。
纳入有幻觉和/或妄想的帕金森病患者。给予阿立哌唑 3 mg/天，根据需要增加或减少剂量。使用简明精神病评定量表（BPRS）、临床总体印象严重程度（CGI-S）量表和精神病反应临床总体印象改善量表、Hoehn & Yahr 分期和统一帕金森病评定量表（UPDRS）第三部分评估运动反应；使用简易精神状态检查（MMSE）和额叶评定量表（FAB）评估认知反应；使用 Schwab 和 England 日常生活活动量表评估患者的日常生活活动，在开始开放标签阿立哌唑治疗前和 2、4 和 12 周后进行评估。该研究在大学医院医疗信息网络中心（注册号：UMIN000007711）注册。
24 名入组患者中有 9 名退出研究。其中，8 名患者因帕金森病症状恶化而停止试验。继续和停止研究的患者在年龄、病程、疾病严重程度以及简易精神状态检查表和额叶评定量表评分方面无差异。然而，在每天服用 3 毫克或更少阿立哌唑的患者中，简明精神病评定量表、临床总体印象严重程度和统一帕金森病评定量表第三部分评分显著改善。
尽管阿立哌唑可能会加重帕金森病患者的帕金森病，但预计幻觉和妄想会有所改善。低剂量使用阿立哌唑可能有助于管理有精神病的帕金森病患者，但仅在密切观察锥体外系症状的情况下使用。
