Double D B, Warren G C, Evans M, Rowlands R P
University Department of Psychiatry, Northern General Hospital, Sheffield, United Kingdom.
Acta Psychiatr Scand. 1993 Nov;88(5):381-4. doi: 10.1111/j.1600-0447.1993.tb03477.x.
Twenty-seven long-term psychiatric inpatients maintained on neuroleptics with concomitant antiparkinsonian medication were entered into a study in which anticholinergic medication was gradually withdrawn in a randomized double-blind within-subjects design. The extrapyramidal symptoms of each patient were compared when taking their usual anticholinergic medication, when taking placebo and when taking no antiparkinsonian drug. The relapse rate on no medication was 14%, and if patients relapsed on no medication they also relapsed on placebo. The relapse rate was not significantly different on active medication. Nor were there significant differences in ratings of parkinsonism or dyskinesia. The lack of difference between double-blind and overt withdrawal does not mean that studies that find a much higher relapse rate are necessarily unaffected by nonspecific factors, as significant unblinding may occur in clinical trials.
27名长期服用抗精神病药物并同时服用抗帕金森药物的精神科住院患者参与了一项研究，该研究采用随机双盲自身对照设计，逐渐停用抗胆碱能药物。比较了每位患者在服用常用抗胆碱能药物时、服用安慰剂时以及不服用抗帕金森药物时的锥体外系症状。不服用药物时的复发率为14%，如果患者在不服用药物时复发，那么在服用安慰剂时也会复发。服用有效药物时的复发率无显著差异。帕金森症或运动障碍的评分也无显著差异。双盲撤药和公开撤药之间缺乏差异并不意味着那些发现复发率高得多的研究必然不受非特异性因素影响，因为在临床试验中可能会发生显著的非盲情况。
