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治疗精神分裂症时,抗精神病药物的最佳维持剂量是多少?

What is the best maintenance dose of neuroleptics in schizophrenia?

作者信息

Baldessarini R J, Davis J M

出版信息

Psychiatry Res. 1980 Oct;3(2):115-22. doi: 10.1016/0165-1781(80)90028-1.

Abstract

Short-term use of neuroleptics as well established for many psychotic disorders; details about long-term use remain less clear. Most long-term studies involved patients diagnosed as chronic schizophrenics and used phenothiazines; responses, dose requirements, and probably diagnosis were highly heterogeneous. Data from controlled studies permitting estimates of the equivalent dose of chlorpromazine to be plotted vs. reduction of relapse rates revealed no significant dose effect between 100 and over 2,000 (median = 310) mg/kg day, no mean difference in outcome at doses above vs. below 310 mg, and a mean relapse of placebo of only 54%. Since maintenance requirements for some patients may be low, the use of minimum effective doses is encouraged and may limit risks of late toxicity, as further long-term studies of the effect of dose are undertaken.

摘要

抗精神病药物的短期使用在许多精神障碍中已得到充分证实;而长期使用的细节仍不太清楚。大多数长期研究涉及被诊断为慢性精神分裂症的患者,并使用了吩噻嗪类药物;反应、剂量需求以及可能的诊断都高度异质。来自对照研究的数据允许绘制氯丙嗪等效剂量与复发率降低的关系图,结果显示在100至超过2000(中位数 = 310)mg/kg/天之间没有显著的剂量效应,剂量高于和低于310mg时结果没有平均差异,安慰剂的平均复发率仅为54%。由于一些患者的维持剂量需求可能较低,因此鼓励使用最小有效剂量,这可能会限制后期毒性风险,因为正在进行关于剂量效应的进一步长期研究。

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