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首页> 外文期刊>The journal of clinical psychiatry >Efficacy of quetiapine and risperidone against depressive symptoms in outpatients with psychosis.
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Efficacy of quetiapine and risperidone against depressive symptoms in outpatients with psychosis.

机译：喹硫平和利培酮对精神病门诊患者抑郁症状的疗效。

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BACKGROUND: The treatment of psychotic symptoms in patients with mood disorders is a complex challenge. Antipsychotic medications in these individuals may be associated with extrapyramidal symptoms (EPS), worsening of depression, and functional impairment. Atypical antipsychotics such as quetiapine and risperidone are associated with a decreased incidence of adverse events such as EPS. The objective of this study was to compare the efficacy and tolerability of quetiapine and risperidone for the treatment of depressive symptoms in outpatients with psychosis. METHOD: In this 4-month, multicenter, open-label trial, patients were randomly assigned in a 3:1 ratio of quetiapine to risperidone, and both drugs were flexibly dosed. Eligible patients had psychoses and demonstrated 1 of several DSM-IV diagnoses, including schizoaffective disorder, bipolar I disorder, major depressive disorder, delusional disorder, Alzheimer's dementia, schizophreniform disorder, vascular dementia, and substance abuse dementia. Patients were classified as mood disordered if they had bipolar disorder, major depressive disorder, or schizoaffective disorder. Efficacy was assessed using the Positive and Negative Syndrome Scale and the Clinical Global Impressions scale. The Hamilton Rating Scale for Depression (HAM-D) was used to assess the level of depressive symptoms. The primary tolerability assessment was presence or absence of substantial EPS, defined as EPS severe enough to require an alteration in treatment. RESULTS: A total of 554 patients were randomly assigned to quetiapine and 175 to risperidone. Mean doses at 16 weeks were 318 mg for quetiapine and 4.4 mg for risperidone. Although both agents produced improvements in mean HAM-D scores, quetiapine produced a greater improvement than risperidone in all patients (p =.0015). Within the mood-diagnosed population, incidences of both substantial EPS (p =.001) and at least moderate EPS (p =.0373) occurred significantly less frequently among patients taking quetiapine. For patients with non-mood diagnoses, incidences of substantial EPS were fewer for patients taking quetiapine than for those taking risperidone (p =.062); however, this was not statistically significant. CONCLUSION: These results suggest that quetiapine may be a useful agent in the management of depressive symptoms in patients with psychosis.
机译：背景：患有情绪障碍的患者的精神病症状的治疗是一个复杂的挑战。这些人的抗精神病药物可能与锥体束外症状（EPS），抑郁加剧和功能障碍有关。非典型抗精神病药物（例如喹硫平和利培酮）与不良事件（例如EPS）的发生率降低相关。这项研究的目的是比较喹硫平和利培酮对精神病患者门诊抑郁症状的疗效和耐受性。方法：在这个为期4个月的多中心开放标签试验中，患者以喹硫平与利培酮的比例为3：1随机分配，并且两种药物均可灵活给药。符合条件的患者患有精神病，并表现出数种DSM-IV诊断中的1种，包括精神分裂症，双相I障碍，重度抑郁症，妄想症，阿尔茨海默氏痴呆症，精神分裂症，血管性痴呆和药物滥用性痴呆。如果患者患有双相情感障碍，重度抑郁症或精神分裂性情感障碍，则将其分类为情绪障碍。使用阳性和阴性综合征量表和临床总体印象量表评估疗效。汉密尔顿抑郁量表（HAM-D）用于评估抑郁症状的水平。主要的耐受性评估为是否存在实质性EPS，定义为严重到需要改变治疗的EPS。结果：共有554例患者被随机分配到喹硫平和175例利培酮。 16周时的平均剂量为喹硫平为318 mg，利培酮为4.4 mg。尽管两种药物均改善了HAM-D的平均评分，但喹硫平在所有患者中的疗效均优于利培酮（p = .015）。在经情绪诊断的人群中，服用喹硫平的患者发生实质性EPS（p = .001）和至少中度EPS（p = .0373）的发生率显着降低。对于没有情绪诊断的患者，喹硫平组患者的实质性EPS发生率低于利培酮组（p = .062）;但是，这在统计上并不显着。结论：这些结果表明喹硫平可能是治疗精神病患者抑郁症状的有用药物。

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