Furmaga K M, DeLeon O A, Sinha S B, Jobe T H, Gaviria M
Department of Psychiatry, University of Illinois at Chicago, USA.
Gen Hosp Psychiatry. 1997 May;19(3):223-8. doi: 10.1016/s0163-8343(97)89884-2.
We report the response to risperidone in seven hospitalized, adult patients who presented psychotic symptoms etiologically related to a general medical condition. The conditions included brain surgery in two, and anticardiolipin syndrome, renal failure, epilepsy, lupus, and metastatic carcinoma in one each. Four patients had failed previous treatment with at least one typical antipsychotic agent. Response to risperidone was assessed by the Brief Psychiatric Rating Scale (BPRS). Serum was collected for measurement of steady-state trough risperidone and 9-hydroxyrisperidone concentrations at effective doses in three patients. Amelioration of psychotic symptoms was noted in all seven patients. Mean (+/- SD) BPRS scores were reduced significantly from baseline (63.0 +/- 15.1) to endpoint (27.0 +/- 3.5; p < 0.01). The mean effective daily dose of risperidone was 3.1 +/- .7 mg and time to response was 4.7 +/- 2.4 days. Risperidone was not present at detectable concentrations in the three patients studied. The mean steady-state trough serum concentration of 9-hydroxyrisperidone in the three patients assessed was 20.3 +/- 9.8 ng/ml. These preliminary findings, which suggest that risperidone is a safe and effective agent in patients with psychotic symptoms due to various medical conditions, need to be confirmed by randomized, antipsychotic comparison trials involving a larger number of patients.
我们报告了7例住院成年患者使用利培酮的反应，这些患者出现了与躯体疾病病因相关的精神病性症状。其中2例患者有脑部手术史，另外1例分别患有抗心磷脂综合征、肾衰竭、癫痫、狼疮和转移性癌。4例患者先前使用至少一种传统抗精神病药物治疗失败。使用简明精神病评定量表（BPRS）评估对利培酮的反应。在3例患者中收集血清，以测量有效剂量下利培酮稳态谷浓度和9-羟利培酮浓度。所有7例患者的精神病性症状均有改善。BPRS评分均值（±标准差）从基线时的（63.0±15.1）显著降至终点时的（27.0±3.5；p<0.01）。利培酮的平均有效日剂量为3.1±0.7mg，起效时间为4.7±2.4天。在研究的3例患者中未检测到利培酮。在评估的3例患者中，9-羟利培酮的平均稳态谷血清浓度为20.3±9.8ng/ml。这些初步发现表明，利培酮在因各种躯体疾病导致精神病性症状的患者中是一种安全有效的药物，但需要通过涉及更多患者的随机抗精神病药物对照试验来证实。
