早期无反应作为后期对精神分裂症抗精神病药物无反应的预测因素:一项随机试验
Yujun Long1, Qiongqiong Wu1, Ye Yang1
1Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 139# Renmin Middle RD, Changsha, 410011, Hunan, China.
BMC medicine
|July 19, 2023
概括
预测精神分裂症的长期抗精神病反应是具有挑战性的. 在第4周的早期不响应,定义为PANSS分数下降<20%,准确预测后来的结果,指导治疗调整.
科学领域:
- 精神病学和行为科学
- 临床药理学 临床药理学
- 精神分裂症治疗研究研究
背景情况:
- 预测早期没有反应的精神分裂症患者的长期抗精神病疗效仍然是一个临床挑战.
- 确定最佳的早期预测标志物对于在精神分裂症管理中及时修改治疗至关重要.
研究的目的:
- 确定精神分裂症患者早期不对抗精神病药物反应的最佳预测截止值.
- 根据早期治疗结果,提高长期不响应的预测.
主要方法:
- 一个多中心,为期8周的,开放标签,随机化试验,涉及中国的19个精神病中心.
- 参与者接受了单独治疗的 olanzapine,risperidone,amisulpride 或 aripiprazole.
- 积极和消极综合征量表 (PANSS) 在基线,第2,4周和第8周进行评估,以确定非响应 (<20%的PANSS分数减少).
主要成果:
- 在第2周,症状减缓值在根据疾病严重程度和抗精神病类型的预测准确度上有所不同.
- 在第二周减少10%的PANSS分数显示出适度精神分裂症和特定抗精神病药物的最佳准确性.
- 在第4周,PANSS分数下降<20%显示了所有严重程度和抗精神病药物的高预测准确度 (89.892.1%).
结论:
- 在第2周早期的症状减少为预测精神分裂症患者晚期抗精神病药物不响应提供了可接受的歧视.
- 在第4周减少20%以下的PANSS得分是长期不响应的强有力的预测指标,无论抗精神病药物或疾病严重程度如何.
- 在前四周内评估治疗反应,特别是在第二至第四周之间,对于指导抗精神病药物改变至关重要.
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