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首页> 外文期刊>Clinical therapeutics >A comparison of the relative safety, efficacy, and tolerability of quetiapine and risperidone in outpatients with schizophrenia and other psychotic disorders: the quetiapine experience with safety and tolerability (QUEST) study.
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A comparison of the relative safety, efficacy, and tolerability of quetiapine and risperidone in outpatients with schizophrenia and other psychotic disorders: the quetiapine experience with safety and tolerability (QUEST) study.

机译：精神分裂症和其他精神疾病门诊患者中喹硫平和利培酮的相对安全性，疗效和耐受性比较：喹硫平的安全性和耐受性经验（QUEST）研究。

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BACKGROUND: The few published direct comparative studies of the tolerability and efficacy of atypical antipsychotic agents were performed in relatively homogeneous populations that may not be typical of patients seen in clinical practice. OBJECTIVE: The Quetiapine Experience with Safety and Tolerability (QUEST) study compared the relative safety, tolerability, and efficacy of quetiapine and risperidone in outpatients with a broad range of psychotic symptoms. METHODS: This was a multicenter, 4-month, open-label, randomized clinical trial. Patients were randomized in a 3:1 ratio to receive quetiapine or risperidone. Doses were adjusted to maximize efficacy and to minimize adverse events. Extrapyramidal symptoms (EPS) were assessed with an EPS checklist; adverse events were recorded. Efficacy was assessed using the Clinical Global Impression (CGI) scale, Positive and Negative Symptom Scale (PANSS), and Hamilton Rating Scale for Depression (HAM-D). RESULTS: A total of 728 patients were randomized, 553 to quetiapine and 175 to risperidone. Mean prescribed doses over the study period were 253.9 mg/d quetiapine and 4.4 mg/d risperidone. At the end of 4 months, EPS declined in both treatment groups, but quetiapine-treated patients were significantly less likely to require dose adjustment or concurrent anti-EPS medication (P < 0.001). The most common adverse events in the quetiapine and risperidone groups were somnolence (31.3% and 15.4%, respectively), dry mouth (14.5% and 6.9%), and dizziness (12.7% and 6.9%). Overall, tolerance to side effects with the 2 drugs, measured by dropout rates, was comparable. At each visit, a higher percentage of quetiapine-treated patients showed improvement on the CGI scale, but there were no significant between-group differences on the PANSS. At end point, quetiapine-treated patients had significantly lower HAM-D scores (P = 0.028). CONCLUSIONS: The results of this study suggest that quetiapine is as effective as risperidone for the treatment of psychotic symptoms, is more effective for depressive symptoms, may have a more favorable EPS profile, and has comparable overall tolerability.
机译：背景：在相对同质的人群中进行了少数非典型抗精神病药的耐受性和功效的已发表的直接比较研究，这在临床实践中可能并不常见。目的：喹硫平具有安全性和耐受性的经验（QUEST）研究比较了喹硫平和利培酮在具有多种精神病症状的门诊患者中的相对安全性，耐受性和疗效。方法：这是一个多中心，4个月，开放标签，随机临床试验。患者以3：1的比例随机分组接受喹硫平或利培酮。调整剂量以使功效最大化并使不良事件最小化。锥体外系症状（EPS）用EPS检查表进行评估;记录不良事件。使用临床总体印象量表（CGI），阳性和阴性症状量表（PANSS）和汉密尔顿抑郁量表（HAM-D）评估疗效。结果：总共728例患者被随机分组​​，其中553例患者使用喹硫平，175例患者使用利培酮。研究期间的平均处方剂量为253.9 mg / d喹硫平和4.4 mg / d利培酮。在4个月末，两个治疗组的EPS均下降，但喹硫平治疗的患者需要调整剂量或同时使用抗EPS药物的可能性大大降低（P <0.001）。喹硫平和利培酮组中最常见的不良事件是嗜睡（分别为31.3％和15.4％），口干（分别为14.5％和6.9％）和头晕（分别为12.7％和6.9％）。总体而言，两种药物对不良反应的耐受性（以辍学率衡量）是可比的。每次访视时，接受喹硫平治疗的患者比例较高，但CGI量表有所改善，但PANSS组间无显着差异。终点时，喹硫平治疗的患者的HAM-D评分明显降低（P = 0.028）。结论：这项研究的结果表明喹硫平在治疗精神病性症状方面与利培酮一样有效，对抑郁症状更有效，可能具有更有利的每股收益特征，并且具有可比的总体耐受性。

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