Liu K L, Lung F W
Department of Psychiatry, 802 Army General Hospital, Kaohsiung, Taiwan, Republic of China.
Kaohsiung J Med Sci. 1996 Dec;12(12):685-90.
Clinically, most of the schizophrenics usually are treated with neuroleptics. This kind of medicine increases the prolactin level in serum that causes sexual dysfunction. In this study, 27 schizophrenics were divided into three groups. After discontinuation of taking the prior medicine for more than two weeks, subjects were treated respectively with fixed doses of haloperidol (20 mg), remoxipride (450 mg), and sulpiride (1800 mg). During hospitalization, an assigned senior resident used Nancy O. Andresen's Scale for the assessment of Positive Symptoms (SAPS) and Negative Symptoms (SANS) as tools to categorize schizophrenic subjects into subtypes, and another senior resident evaluated the effectiveness of the treatment once a week with the Brief Psychiatric Rating Scale (BPRS). Prolactin level in serum was monitored weekly with fluorescent assay. The Generalized Estimating Equation-I was utilized to analyze the data. The results show that all of the three medicines cause elevation of prolactin level in serum, and sulpiride causes the highest elevation of prolactin level in this study. There is no difference between the subtype of schizophrenia and prolactin reaction. There is also no correlation between the degree of elevation in prolactin and the effectiveness of treatment. However, there is a statistically significant difference in the serum levels between genders. After being treated with antipsychotics, female patients are more likely than male patients to have an elevated prolactin serum level. In conclusion, this study suggests that physicians should be more cautious while treating female psychotic patients with sulpiride.
临床上,大多数精神分裂症患者通常使用抗精神病药物进行治疗。这类药物会使血清催乳素水平升高,从而导致性功能障碍。在本研究中,27名精神分裂症患者被分为三组。在停用先前药物两周以上后,受试者分别接受固定剂量的氟哌啶醇(20毫克)、瑞莫必利(450毫克)和舒必利(1800毫克)治疗。住院期间,指定的住院医师使用南希·O·安德烈森的阳性症状评定量表(SAPS)和阴性症状评定量表(SANS)作为工具,将精神分裂症患者分为不同亚型,另一位住院医师每周使用简明精神病评定量表(BPRS)评估治疗效果。每周用荧光分析法监测血清催乳素水平。采用广义估计方程-I分析数据。结果表明,这三种药物都会导致血清催乳素水平升高,在本研究中舒必利导致的催乳素水平升高幅度最大。精神分裂症亚型与催乳素反应之间没有差异。催乳素升高程度与治疗效果之间也没有相关性。然而,不同性别之间的血清水平存在统计学上的显著差异。接受抗精神病药物治疗后,女性患者比男性患者更易出现血清催乳素水平升高。总之,本研究表明,医生在使用舒必利治疗女性精神病患者时应更加谨慎。