Akiyama K, Tsuchida K, Kanzaki A, Ujike H, Hamamura T, Kondo K, Mutoh S, Miyanagi K, Kuroda S, Otsuki S
Department of Neuropsychiatry, Okayama University Medical School, Japan.
Biol Psychiatry. 1995 Nov 15;38(10):639-48. doi: 10.1016/0006-3223(94)00383-1.
Plasma homovanillic acid (pHVA) levels were measured and the Brief Psychiatric Rating Scale (BPRS) scores were evaluated in 26 schizophrenic patients who had either never been medicated (neuroleptic-naive, first-episode subjects) or whose condition had become exacerbated following neuroleptic discontinuance (exacerbated subjects). All the subjects received medication with a fixed dose of a neuroleptic (haloperidol or fluphenazine, both 9 mg/day) for the first week and variable doses for the subsequent 4 weeks. In the neuroleptic-naive subjects, pHVA levels increased significantly 1 week after starting the protocol; this increase correlated significantly with clinical improvement of the BPRS positive symptom scores at week 5. In the neuroleptic-naive subjects, pHVA levels had declined to the baseline level by week 5. In the exacerbated subjects, there were no significant correlations between pHVA level changes at week 1 and later improvements of the BPRS positive symptom scores. These results suggest that the rise in pHVA levels occurring within 1 week after starting a fixed neuroleptic dose may predict a favorable clinical response in neuroleptic-naive schizophrenic patients.
对26例从未接受过药物治疗（初发未用药、首发患者）或在停用抗精神病药物后病情加重（病情加重患者）的精神分裂症患者，测量了血浆高香草酸（pHVA）水平并评估了简明精神病评定量表（BPRS）评分。所有受试者在第一周接受固定剂量的抗精神病药物（氟哌啶醇或氟奋乃静，均为9毫克/天）治疗，随后4周接受可变剂量治疗。在初发未用药的受试者中，开始治疗方案1周后pHVA水平显著升高；这种升高与第5周时BPRS阳性症状评分的临床改善显著相关。在初发未用药的受试者中，到第5周时pHVA水平已降至基线水平。在病情加重的受试者中，第1周时pHVA水平变化与随后BPRS阳性症状评分的改善之间无显著相关性。这些结果表明，开始固定剂量抗精神病药物治疗后1周内pHVA水平的升高可能预示初发未用药的精神分裂症患者有良好的临床反应。
