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首页> 外文期刊>CNS drug reviews >Ziprasidone for schizophrenia and bipolar disorder: a review of the clinical trials.
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Ziprasidone for schizophrenia and bipolar disorder: a review of the clinical trials.

机译：齐帕西酮治疗精神分裂症和躁郁症：临床试验综述。

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Ziprasidone is a newer "atypical" or "second-generation" antipsychotic. Oral ziprasidone (ziprasidone hydrochloride) is approved by the U.S. Food and Drug Administration (FDA) for the treatment of schizophrenia, and acute manic or mixed episodes associated with bipolar disorder (with or without psychotic features). Ziprasidone intramuscular (ziprasidone mesylate) is FDA-approved for acute agitation in patients with schizophrenia. Oral ziprasidone appears efficacious, and has been shown to have some limited clinical advantages over chlorpromazine and haloperidol in ameliorating negative symptoms of schizophrenia. In Phase 2 of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) for schizophrenia, ziprasidone did not match the clinical performance of olanzapine and risperidone, appearing closer in overall effectiveness to quetiapine. The rate of dose titration and the dose achieved may have an important bearing on ziprasidone's efficacy profile. In studies of usage for acute agitationin individuals with schizophrenia, intramuscular ziprasidone has been shown to be efficacious and relatively well tolerated. Regarding tolerability, ziprasidone, has important advantages in that it is not associated with clinically significant weight gain or adverse changes in cholesterol, triglycerides, or glycemic control, and patients may experience moderate improvement in these measures when switching to ziprasidone from a different antipsychotic agent. It also lacks significant persistent effects on prolactin levels, is not anticholinergic, and only infrequently causes extrapyramidal side effects or postural hypotension, although it can be associated with somnolence. This tolerability profile may be quite valuable in the treatment of some patients. Ziprasidone may prolong the electrocardiogram (ECG) QTc interval (QT interval corrected for heart rate by a standard algorithm), but after 5 years' clinical availability ziprasidone (by itself) does not appear to pose a substantial clinical problem in this regard. Therefore, ziprasidone may be considered a first-line drug option in the treatment of schizophrenia or manic episodes, but, in view of the differences among antipsychotic medications, drug selection should be guided by the patient's individual characteristics and situation.
机译：齐帕西酮是一种较新的“非典型”或“第二代”抗精神病药。口服齐拉西酮（盐酸齐拉西酮）已获得美国食品和药物管理局（FDA）的批准，用于治疗精神分裂症以及与躁郁症相关的急性躁狂或混合发作（有或没有精神病性特征）。 FDA批准肌酸齐普拉西酮（甲磺酸齐拉西酮）用于精神分裂症患者的急性躁动。口服齐拉西酮似乎有效，并且在缓解精神分裂症的阴性症状方面比氯丙嗪和氟哌啶醇具有有限的临床优势。在针对精神分裂症的临床抗精神病药物干预效果试验（CATIE）的第二阶段中，齐拉西酮与奥氮平和利培酮的临床表现不匹配，总体疗效似乎与喹硫平更为接近。剂量的滴定速率和达到的剂量可能对齐拉西酮的疗效有重要影响。在对精神分裂症患者进行急性躁动的使用的研究中，肌内齐拉西酮已被证明是有效的并且耐受性相对较好。关于耐受性，齐拉西酮具有重要的优势，因为它与临床上体重的显着增加或胆固醇，甘油三酸酯或血糖控制的不良变化无关，并且当从另一种抗精神病药转为齐拉西酮时，患者在这些措施上可能会经历中等程度的改善。它也对催乳素水平缺乏显着的持续作用，不是抗胆碱能的，尽管它可能与嗜睡有关，但很少引起锥体束外副作用或体位性低血压。这种耐受性概况在某些患者的治疗中可能非常有价值。 Ziprasidone可能会延长心电图（ECG）QTc间隔（通过标准算法校正了心率的QT间隔），但是5年临床可用后，ziprasidone（本身）似乎在这方面没有构成实质性的临床问题。因此，齐拉西酮可能被认为是治疗精神分裂症或躁狂发作的一线药物，但是鉴于抗精神病药物之间的差异，应根据患者的个人特点和情况来指导药物的选择。

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