Litman R E, Su T P, Potter W Z, Hong W W, Pickar D
National Institute of Mental Health, Experimental Therapeutics Branch, Bethesda MD 20892-1380, USA.
Br J Psychiatry. 1996 May;168(5):571-9. doi: 10.1192/bjp.168.5.571.
We investigated whether antagonism of alpha 2 adrenergic receptors would augment treatment response in schizophrenia, by administering idazoxan, an alpha 2 antagonist drug, to treatment-resistant patients on typical neuroleptics.
Seventeen hospitalised treatment-resistant patients with DSM-III-R schizophrenia or schizoaffective disorder were studied on typical neuroleptic treatment, on treatment with idazoxan plus typical neuroleptic, and after discontinuation of idazoxan, in fixed, non-random order, and under double-blind, placebo-controlled conditions.
The addition of idazoxan to fluphenazine treatment resulted in significant reductions of global psychosis and total, positive and negative symptoms on the Brief Psychiatric Rating Scale, compared to neuroleptic treatment alone. Symptom improvement significantly correlated with idazoxan-induced changes in indices of noradrenergic function. In a subgroup of patients, idazoxan plus typical neuroleptic treatment compared favourably with clozapine treatment, when both were compared to typical neuroleptic treatment alone.
The antagonism of alpha 2 receptors augmented therapeutic response to typical neuroleptic treatment in treatment-resistant patients with schizophrenia. This antagonism may contribute to clozapine's superior antipsychotic effects.
我们通过给使用典型抗精神病药物治疗无效的患者服用α2拮抗剂药物吲哚唑烷，来研究α2肾上腺素能受体拮抗作用是否会增强精神分裂症的治疗反应。
对17名住院的、使用典型抗精神病药物治疗无效的DSM-III-R精神分裂症或分裂情感性障碍患者进行研究，按照固定的、非随机顺序，在双盲、安慰剂对照的条件下，分别接受典型抗精神病药物治疗、吲哚唑烷加典型抗精神病药物治疗以及吲哚唑烷停药后治疗。
与单独使用抗精神病药物治疗相比，在氟奋乃静治疗中加用吲哚唑烷可使简明精神病评定量表中的总体精神病症状以及总症状、阳性症状和阴性症状显著减轻。症状改善与吲哚唑烷引起的去甲肾上腺素能功能指标变化显著相关。在一组患者中，将吲哚唑烷加典型抗精神病药物治疗与氯氮平治疗单独与典型抗精神病药物治疗进行比较时，前者表现良好。
α2受体拮抗作用增强了对使用典型抗精神病药物治疗无效的精神分裂症患者的治疗反应。这种拮抗作用可能有助于氯氮平具有更好的抗精神病效果。
