Weiden P, Schooler N R, Severe J B, Lee J H, Schulz S C
St. Luke's/Roosevelt Hospital Center, New York, NY 10012.
Psychopharmacol Bull. 1993;29(2):269-75.
Little is known about the stabilization phase of schizophrenia. To address this deficiency, we studied the prescribing patterns of fluphenazine decanoate (FZD) for a cohort of schizophrenic patients recovering from an acute psychotic episode who were being followed in the Treatment Strategies in Schizophrenia (TSS) multi-site maintenance study. Dosage data from the first 208 successfully-stabilized TSS subjects were examined. We hypothesized five groups on the basis of dosage prescribed and dosage stability over time: (1) STABLE HIGH, (2) STABLE INTERMEDIATE, (3) STABLE LOW, (4) UNSTABLE RAISING, and (5) UNSTABLE LOWERING. The dosage patterns were rated and analyzed against predictive and outcome variables. Most of the subjects (n = 168, or 82%) fit one of the five hypothesized dosage pattern groups. Our preliminary findings are as follows: (1) all groups improved during stabilization; (2) baseline symptom severity did not distinguish among dosage pattern groups; (3) STABLE dose groups needed less time to stabilize than did the UNSTABLE groups, but the STABLE groups did not have a better medication response; (4) many of the UNSTABLE LOWERING subjects apparently received a "loading dose" strategy (e.g., initial FZD dose > or = 25 mg), which was paradoxically associated with a longer stabilization time.
关于精神分裂症的稳定期，人们了解甚少。为了弥补这一不足，我们对一组从急性精神病发作中康复的精神分裂症患者的氟奋乃静癸酸酯（FZD）处方模式进行了研究，这些患者参与了精神分裂症治疗策略（TSS）多中心维持研究。我们检查了TSS研究中最初208名成功实现病情稳定的受试者的剂量数据。我们根据规定剂量和随时间的剂量稳定性假设了五组：（1）稳定高剂量组，（2）稳定中等剂量组，（3）稳定低剂量组，（4）不稳定剂量增加组，以及（5）不稳定剂量降低组。针对预测变量和结果变量对剂量模式进行了评级和分析。大多数受试者（n = 168，即82%）符合五个假设剂量模式组中的一组。我们的初步研究结果如下：（1）所有组在病情稳定期间均有改善；（2）基线症状严重程度在各剂量模式组之间并无差异；（3）稳定剂量组比不稳定组需要更少的时间来实现病情稳定，但稳定组的药物反应并未更好；（4）许多不稳定剂量降低组的受试者显然采用了“负荷剂量”策略（例如，初始FZD剂量≥25毫克），但反常的是，这与更长的病情稳定时间相关。
