氯氮平用于治疗难治性躁狂症。
Clozapine for treatment-refractory mania.
作者信息
Calabrese J R, Kimmel S E, Woyshville M J, Rapport D J, Faust C J, Thompson P A, Meltzer H Y
机构信息
Mood Disorders Program, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
出版信息
Am J Psychiatry. 1996 Jun;153(6):759-64. doi: 10.1176/ajp.153.6.759.
OBJECTIVE
The efficacy of clozapine for treatment-resistant mania was examined in a prospective trial for patients with bipolar or schizoaffective disorder.
METHOD
The subjects were 25 acutely manic patients with either bipolar disorder (N = 10) or schizoaffective disorder-bipolar subtype (N = 15) for whom lithium, anticonvulsants, and neuroleptics had been ineffective, had produced intolerable side effects, or both. After a 7-day washout, the patients were treated with clozapine monotherapy. They were evaluated over 13 weeks with the Young Mania Rating Scale and the Brief Psychiatric Rating Scale (BPRS).
RESULTS
Of the 25 patients, 18 (72%) exhibited marked improvement on the Young Mania Rating Scale, and eight (32%) exhibited marked improvement on the BPRS. The bipolar patients as compared to schizo-affective patients, and the nonrapid as compared to rapid cyclers, had significantly greater improvement in total BPRS score.
CONCLUSIONS
These results suggest that clozapine is an effective therapy for treatment-resistant bipolar and schizoaffective mania.
目的
在一项针对双相情感障碍或分裂情感性障碍患者的前瞻性试验中，研究氯氮平治疗难治性躁狂症的疗效。
方法
研究对象为25例急性躁狂患者，其中双相情感障碍患者10例，分裂情感性障碍双相亚型患者15例，这些患者使用锂盐、抗惊厥药和抗精神病药治疗无效、出现无法耐受的副作用或两者皆有。经过7天的洗脱期后，患者接受氯氮平单一疗法治疗。在13周内使用杨氏躁狂量表和简明精神病评定量表（BPRS）对他们进行评估。
结果
25例患者中，18例（72%）在杨氏躁狂量表上显示出显著改善，8例（32%）在BPRS上显示出显著改善。双相情感障碍患者与分裂情感性障碍患者相比，非快速循环型患者与快速循环型患者相比，BPRS总分改善更为显著。
结论
这些结果表明，氯氮平是治疗难治性双相情感障碍和分裂情感性躁狂症的有效疗法。
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