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亚洲和西班牙裔精神分裂症门诊患者的抗精神病药物剂量

Neuroleptic dosing in Asian and Hispanic outpatients with schizophrenia.

作者信息

Ruiz S, Chu P, Sramek J, Rotavu E, Herrera J

机构信息

Mount Sinai School of Medicine, Elmhurst, NY, USA.

出版信息

Mt Sinai J Med. 1996 Oct-Nov;63(5-6):306-9.

PMID:8898532
Abstract

Recent studies suggest that minorities may have higher plasma levels caused by ethnic variations in pharmacokinetics under standard neuroleptic treatment; they would be at increased risk for extrapyramidal side effects and more likely to be treatment noncompliant. This study examined the prescribing pattern of antipsychotic medication to minority schizophrenics in outpatient psychiatric programs developed to meet their treatment needs. A computer search was conducted of registered clients in a Hispanic and Asian outpatient clinic(s). Hispanic and Asian patients with schizophrenia were identified and for purposes of comparison, a third sample of consecutively drawn outpatients with a diagnosis of "schizophrenia" registered in the outpatient clinic proper were selected. All outpatient medical records were secured and neuroleptic dosing patterns extracted and quantified. Neuroleptic doses were converted to chlorpromazine equivalents and corrected for body weight to a standard of 68 kg. One way analysis of variance procedures were used to compare both the actual and standardized neuroleptic doses across the three samples and revealed a significant main effect for both actual (p < 0.05) and standardized dose (p < 0.05). With regard to the former secondary analysis yielded significant differences between the clinic sample and the Hispanic (p < 0.05) and Asian (p < 0.05) samples, which did not differ significantly from each other but which received significantly less drugs than the other patient population. These results were similar to the standardized dose comparison. The findings replicate previous inpatient reports and have implications for cross-cultural treatment programs.

摘要

近期研究表明,在标准抗精神病药物治疗下,少数族裔可能因药代动力学的种族差异而具有较高的血浆水平;他们发生锥体外系副作用的风险增加,且更有可能不依从治疗。本研究调查了在为满足少数族裔精神分裂症患者治疗需求而设立的门诊精神病项目中,抗精神病药物的处方模式。对一家西班牙裔和亚裔门诊诊所的注册患者进行了计算机检索。识别出西班牙裔和亚裔精神分裂症患者,为作比较,还选取了在该门诊诊所连续就诊且诊断为“精神分裂症”的第三组门诊患者样本。获取了所有门诊病历,提取并量化了抗精神病药物的给药模式。将抗精神病药物剂量换算为氯丙嗪等效剂量,并根据体重校正至68千克的标准。采用单因素方差分析程序比较三个样本的实际和标准化抗精神病药物剂量,结果显示实际剂量(p < 0.05)和标准化剂量(p < 0.05)均有显著的主效应。关于前者,二次分析显示诊所样本与西班牙裔样本(p < 0.05)和亚裔样本(p < 0.05)之间存在显著差异,西班牙裔和亚裔样本之间无显著差异,但他们接受的药物明显少于其他患者群体。这些结果与标准化剂量比较结果相似。这些发现重复了之前的住院患者报告,并对跨文化治疗项目具有启示意义。

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