Freedman R, Kirch D, Bell J, Adler L E, Pecevich M, Pachtman E, Denver P
Acta Psychiatr Scand. 1982 Jan;65(1):35-45. doi: 10.1111/j.1600-0447.1982.tb00819.x.
Antipsychotic effects of clonidine were evaluated in one schizoaffective and seven schizophrenic patients, using a double-blind, cross-over design to compare placebo, clonidine, and standard neuroleptic drugs. Mean improvement on clonidine and neuroleptics was equal, and improvement scores on the two treatments were closely correlated for individual patients. Clonidine was selected because it blocks noradrenergic but not dopaminergic neurotransmission. Patients were selected because of co-existing psychosis and tardive dyskinesia, a movement disorder thought to be caused by the antidopaminergic properties of the neuroleptics. For all patients, dyskinesia improved when neuroleptics were discontinued during clonidine and placebo periods of the study. The data provide preliminary evidence that clonidine may be an effective alternative to neuroleptics, particularly for patients for whom the dopaminergic blocking action of the neuroleptics is undesirable. The study also prompts re-evaluation of theories of a unique role for dopamine in schizophrenia.
使用双盲交叉设计，对比安慰剂、可乐定和标准抗精神病药物，在1例分裂情感性障碍患者和7例精神分裂症患者中评估了可乐定的抗精神病作用。可乐定和抗精神病药物的平均改善效果相当，且两种治疗的改善评分在个体患者中密切相关。选择可乐定是因为它阻断去甲肾上腺素能而非多巴胺能神经传递。选择这些患者是因为他们同时存在精神病和迟发性运动障碍，后者是一种被认为由抗精神病药物的抗多巴胺能特性引起的运动障碍。对于所有患者，在研究的可乐定和安慰剂阶段停用抗精神病药物时，运动障碍有所改善。这些数据提供了初步证据，表明可乐定可能是抗精神病药物的有效替代药物，特别是对于那些抗精神病药物的多巴胺能阻断作用不理想的患者。该研究还促使重新评估多巴胺在精神分裂症中独特作用的理论。
