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卡立普嗪用于早期精神病性障碍阴性症状的研究:一项为期6个月随访的试点研究

Cariprazine for negative symptoms in early psychosis: a pilot study with a 6-month follow-up.

作者信息

Pappa Sofia, Kalniunas Arturas, Maret Jose

机构信息

West London NHS Trust, London, United Kingdom.

Imperial College London, London, United Kingdom.

出版信息

Front Psychiatry. 2023 Jun 22;14:1183912. doi: 10.3389/fpsyt.2023.1183912. eCollection 2023.

Abstract

BACKGROUND

Cariprazine, a novel antipsychotic drug that is a partial agonist with preferential binding to the D3 receptor, has demonstrated efficacy in clinical trials across all symptom domains, including negative symptoms, which can occur early in the course of psychotic illness. However, evidence, to date regarding its effects in early psychosis patients with primary negative symptoms has been limited.

OBJECTIVES

To evaluate the efficacy of cariprazine for negative symptoms in early psychosis patients.

METHODS

Demographic and clinical information of the study population were collected from the electronic records and PANSS scale administered at baseline, 3 and 6 months. Tolerability and discontinuation reasons, where applicable, were also recorded.

RESULTS

Ten patients with early psychosis (four men and six women, mean age - 25.5  years) with prominent or predominant negative symptoms were treated with cariprazine (range 1.5 - 3 mg). Three patients discontinued cariprazine within the first 3  months due to patient choice, lack of response and non-compliance, respectively. In the remaining patients, there was a significant reduction in the mean negative PANSS score from baseline to 6 months (from 26.3 to 10.6), mean total PANSS score (from 81.4 to 43.3) and in the mean positive PANSS score (from 14.4 to 9.9) which correspond to a 53.1, 41.5, and 28.5% mean score reduction.

CONCLUSION

This pilot study suggests that cariprazine is a safe and effective treatment in early psychosis, particularly for the alleviation of negative symptoms which remains an area of unmet treatment need.

摘要

背景

卡立哌嗪是一种新型抗精神病药物,是一种对D3受体具有优先结合作用的部分激动剂,在包括阴性症状(可在精神病病程早期出现)在内的所有症状领域的临床试验中均显示出疗效。然而,迄今为止,关于其对原发性阴性症状的早期精神病患者的影响的证据有限。

目的

评估卡立哌嗪对早期精神病患者阴性症状的疗效。

方法

从电子记录以及在基线、3个月和6个月时施用的阳性和阴性症状量表(PANSS)中收集研究人群的人口统计学和临床信息。还记录了耐受性和停药原因(如适用)。

结果

10例有突出或主要阴性症状的早期精神病患者(4名男性和6名女性,平均年龄25.5岁)接受了卡立哌嗪治疗(剂量范围为1.5 - 3mg)。3例患者分别因患者自身选择、无反应和不依从在最初3个月内停用卡立哌嗪。在其余患者中,从基线到6个月,阴性PANSS平均得分(从26.3降至10.6)、PANSS总平均得分(从81.4降至43.3)和阳性PANSS平均得分(从14.4降至9.9)均有显著降低,分别相当于平均得分降低53.1%、41.5%和28.5%。

结论

这项初步研究表明,卡立哌嗪在早期精神病治疗中是一种安全有效的治疗方法,特别是对于缓解阴性症状,而阴性症状仍然是未满足治疗需求的领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/343d/10323827/81f5f3937423/fpsyt-14-1183912-g001.jpg

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