Steingard S, Allen M, Schooler N R
University of Vermont College of Medicine, Waterbury.
J Clin Psychiatry. 1994 Nov;55(11):470-2.
Maintenance antipsychotic medications greatly diminish the risk of relapse in schizophrenic patients. A significant number, however, will relapse despite ongoing drug treatment. This is a report of a pilot study of a group of schizophrenic patients who relapsed despite having been compliant with treatment.
The authors studied 32 schizophrenic patients who had been compliant with pharmacologic treatment but who had suffered a relapse and were admitted to the hospital. Maintained on their usual pharmacologic treatment, they also received in a double-blind fashion either fluphenazine or placebo. Clinical assessments were done on Day 1 and Day 10.
The authors found no effect of additional neuroleptic treatment on outcome. Two-thirds of the subjects showed at least moderate improvement during the study. Subjects who were experiencing greater severity of depression on admission were more likely to improve. There was no association between baseline ratings of psychosis and outcome.
This study offers preliminary evidence that increasing the dose of neuroleptic does not improve outcome in schizophrenics who have relapsed while taking antipsychotic medications. Most of these patients will improve during the course of a brief hospitalization.
维持性抗精神病药物可大幅降低精神分裂症患者复发的风险。然而,仍有相当一部分患者尽管持续接受药物治疗仍会复发。本文报告了一项针对一组尽管坚持治疗但仍复发的精神分裂症患者的试点研究。
作者研究了32名坚持药物治疗但复发并入院的精神分裂症患者。在维持其常规药物治疗的同时,他们还以双盲方式接受氟奋乃静或安慰剂治疗。在第1天和第10天进行临床评估。
作者发现额外的抗精神病药物治疗对治疗结果没有影响。三分之二的受试者在研究期间至少有中度改善。入院时抑郁症状更严重的受试者更有可能改善。精神病的基线评分与治疗结果之间没有关联。
本研究提供了初步证据,表明增加抗精神病药物剂量并不能改善在服用抗精神病药物期间复发的精神分裂症患者的治疗结果。这些患者中的大多数在短暂住院期间病情会有所改善。