里斯佩里,哈洛佩里多尔和安慰剂治疗智力障碍患者的攻击性挑战性行为:一项随机对照试验
Peter Tyrer1, Patricia C Oliver-Africano, Zed Ahmed
1Department of Psychological Medicine, Imperial College, London, UK. p.tyrer@imperial.ac.uk
Lancet (London, England)
|January 8, 2008
概括
与安慰剂相比,抗精神病药物在智力障碍的成年人中没有显著改善侵略性行为. 这些发现表明,抗精神病药物不是适合这种人群的常规治疗.
科学领域:
- 临床心理学 临床心理学
- 心理药理学 心理药理学
- 智力障碍研究 智力障碍研究
背景情况:
- 在智力障碍的成年人中,具有攻击性挑战性行为是常见的.
- 对这种行为,经常使用抗精神病药物,但缺乏证据.
- 典型的 (haloperidol) 和非典型的 (risperidone) 抗精神病药物经常被处方.
研究的目的:
- 为了比较haloperidol,risperidone和安慰剂在治疗智力障碍成年人的攻击性行为方面的疗效.
- 评估侵略性,异常行为,生活质量和不良影响的变化.
主要方法:
- 一项随机对照试验,涉及86名非精神病成年人,具有具有攻击性挑战性行为.
- 参与者被分配给利,利或安慰剂.
- 对攻击性 (修改过度攻击量表 - MOAS),行为,生活质量和不良影响的评估在26周内进行.
主要成果:
- 在4周后,所有组的攻击性都显著下降,而安慰剂组显示出最大的减少 (与基线相比79%).
- 在抗精神病组和安慰剂组之间,没有发现减少侵略或不良影响的显著差异.
- 接受安慰剂的患者没有表现出比服用抗精神病药物的患者更糟糕的反应.
结论:
- 抗精神病药物没有证据支持作为常规治疗智力障碍患者的攻击性挑战性行为.
- 这项研究质疑目前为这一患者组开处方抗精神病药物的临床实践.
- 应考虑替代性或非药物干预措施.
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