Hedges S, El-Mallakh R S, Issa F, Elkashef A, Bigelow L B, Wyatt R J
Seven Counties Services, Louisville, Kentucky 40202, USA.
Ann Clin Psychiatry. 1998 Mar;10(1):3-7. doi: 10.1023/a:1026194411452.
Clonidine is a centrally acting antihypertensive and has been prescribed widely for more than 20 years. Because it decreases central norepinephrine activity, clonidine has been investigated as an antipsychotic. In most of the preliminary studies, clonidine was tested as the sole antipsychotic agent. We performed a double-blind, placebo-controlled, crossover study to compare a placebo plus a neuroleptic to clonidine plus a neuroleptic in a group of 16 chronically psychotic patients. Of these 16, 3 dropped out secondary to side effects of the clonidine and 1 withdrew from the study. The clonidine dosage varied from 0.2 to 0.6 mg per day. The concurrent neuroleptic (one of the following: haloperidol, thiothixene, thioridazine, mesoridazine, or fluphenazine) averaged 34 mg per day of haloperidol equivalents. Symptoms were monitored using the Psychiatric Symptoms Assessment Scale. The data provided evidence that a clonidine/neuroleptic combination was not more effective than a neuroleptic alone in this group of patients. These data suggest that the central antinorepinephrine activity of a neuroleptic is not potentiated further by clonidine.
可乐定是一种中枢性抗高血压药物，已广泛应用20多年。由于它能降低中枢去甲肾上腺素活性，可乐定已被作为一种抗精神病药物进行研究。在大多数初步研究中，可乐定作为唯一的抗精神病药物进行测试。我们进行了一项双盲、安慰剂对照、交叉研究，以比较16例慢性精神病患者中安慰剂加一种抗精神病药物与可乐定加一种抗精神病药物的疗效。这16例患者中，3例因可乐定的副作用而退出，1例退出研究。可乐定剂量为每天0.2至0.6毫克。同时使用的抗精神病药物（以下之一：氟哌啶醇、替沃噻吨、硫利达嗪、美索达嗪或氟奋乃静）平均相当于每天34毫克氟哌啶醇。使用精神症状评估量表监测症状。数据表明，在这组患者中，可乐定/抗精神病药物联合使用并不比单独使用抗精神病药物更有效。这些数据表明，抗精神病药物的中枢抗去甲肾上腺素活性不会因可乐定而进一步增强。
