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氯氮平作为情感稳定剂治疗分裂情感性障碍:三个月随访期间的疗效。

Clozapine as a mood stabiliser for schizoaffective disorder: Effectiveness during a three-month follow-up.

机构信息

TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Spain; Department of Mental Health, Provincial Hospital Consortium of Castellon, Spain.

TXP Research Group, Universidad Cardenal Herrera-CEU, CEU Universities, Spain; Department of Mental Health, Provincial Hospital Consortium of Castellon, Spain.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2024 Dec 20;135:111090. doi: 10.1016/j.pnpbp.2024.111090. Epub 2024 Jul 15.

Abstract

Clozapine has shown signs of effectiveness in treating symptoms of schizoaffective disorder, although little research has been carried out to specifically assess this question. The objective of this current work was to analyse the mood-stabilising effectiveness and tolerability of clozapine in patients with schizoaffective disorder. This was a prospective, longitudinal, and quasi-experimental trial with three months of follow-up in patients with refractory schizoaffective disorder (PANSS score exceeding 80). Clinical response was evaluated through monthly visits using the YMRS, MADRS, CDSS, CGI-S and UKU. Twenty-seven participants (63% men, 37% women) with a mean age of 32.56 years were included. Clozapine significantly reduced the symptoms of mania, as measured by the YMRS (pre-treatment: 16.19, post-treatment: 0.67; p < 0.01) as well as the symptoms of depression, quantified with the CDSS (pre-treatment: 6.11, post-treatment: 0.67; p < 0.01), MADRS (pre-treatment: 9.56, post-treatment: 1.07; p < 0.01), and CGI-S (pre-treatment: 4.74, post-treatment: 1.15; p < 0.01). The prescription of clozapine significantly reduced the average daily dose of neuroleptics, measured in mg of chlorpromazine (pre-treatment: 1253.55, post-treatment: 742.59; p < 0.01) and hypnosedatives, measured in mg of diazepam (pre-treatment: 33.88, post-treatment: 5.74; p < 0.05) required in these patients. Patient-perceived tolerability, measured with the UKU, also improved during follow-up (pre-treatment: 12.89, post-treatment: 8.14; p < 0.01). The efficacy of clozapine was significant for the affective symptoms of schizoaffective disorder, thereby improving patient tolerability and permitting reductions in the other medications the patients used.

摘要

氯氮平已显示出在治疗分裂情感障碍症状方面的有效性,尽管针对这一问题的研究很少。本项当前工作的目的是分析氯氮平在分裂情感障碍患者中的稳定情绪的有效性和耐受性。这是一项前瞻性、纵向和准实验性试验,对难治性分裂情感障碍患者(PANSS 评分超过 80)进行了为期三个月的随访。通过每月使用 YMRS、MADRS、CDSS、CGI-S 和 UKU 进行访视评估临床反应。共纳入 27 名参与者(63%为男性,37%为女性),平均年龄为 32.56 岁。氯氮平显著降低了 YMRS(治疗前:16.19,治疗后:0.67;p<0.01)以及 CDSS(治疗前:6.11,治疗后:0.67;p<0.01)、MADRS(治疗前:9.56,治疗后:1.07;p<0.01)和 CGI-S(治疗前:4.74,治疗后:1.15;p<0.01)评定的躁狂症状,以及氯氮平治疗降低了平均日剂量的抗精神病药物(以氯丙嗪 mg 计)(治疗前:1253.55,治疗后:742.59;p<0.01)和催眠药物(以安定 mg 计)(治疗前:33.88,治疗后:5.74;p<0.05)。用 UKU 测量的患者感知耐受性也在随访期间得到改善(治疗前:12.89,治疗后:8.14;p<0.01)。氯氮平对分裂情感障碍的情感症状有效,从而提高了患者的耐受性,并允许减少患者使用的其他药物。

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