Minami H, Nakahara T, Miyahara A, Nakane Y
Department of Neuropsychiatry, Nagasaki Municipal Hospital, Japan.
Psychiatry Clin Neurosci. 1997 Aug;51(4):217-22. doi: 10.1111/j.1440-1819.1997.tb02586.x.
Thirty-seven newly admitted schizophrenic patients were treated with an open and flexible dosage of chlorpromazine for 3 months after receiving a test dose. Levels of chlorpromazine, demethylated chlorpromazine and chlorpromazine sulfoxide 3 h after the test dose were measured. Twenty-three patients responded to long-term chlorpromazine treatment but 14 did not, a rate of 62.2%. A discriminant function analysis was performed using variables relating to the patients, backgrounds added to the ratios of plasma drug levels separately by sex to increase predictability over the level of previous studies. The obtained equations were applied to 23 newly admitted schizophrenic patients, with the prescription of chlorpromazine for designated responders and haloperidol for designated non-responders for 4 weeks. The patients in the latter study responded better than those of the former with chlorpromazine alone; 71.4 and 88.9% of chlorpromazine- and haloperidol-treated groups improved, respectively, for an overall rate of 78.3%. However, the chlorpromazine-treated group had a lower level of positive symptoms than the haloperidol-treated group before treatment and this and other differences between the groups should be further examined.
37名新入院的精神分裂症患者在接受试验剂量后，以开放且灵活的剂量服用氯丙嗪进行为期3个月的治疗。测量了试验剂量后3小时氯丙嗪、去甲基氯丙嗪和氯丙嗪亚砜的水平。23名患者对氯丙嗪长期治疗有反应，但14名患者无反应，有效率为62.2%。进行判别函数分析，使用与患者相关的变量，并按性别分别将血浆药物水平的比率添加到背景中，以提高预测能力，超过先前研究的水平。将得到的方程应用于23名新入院的精神分裂症患者，为指定的有反应者开具氯丙嗪处方，为指定的无反应者开具氟哌啶醇处方，为期4周。后一项研究中的患者比前一项仅使用氯丙嗪的患者反应更好；氯丙嗪治疗组和氟哌啶醇治疗组的改善率分别为71.4%和88.9%，总体有效率为78.3%。然而，氯丙嗪治疗组在治疗前的阳性症状水平低于氟哌啶醇治疗组，两组之间的这种差异和其他差异应进一步研究。
