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首页> 外文期刊>Journal of psychopharmacology >Oral risperidone with lorazepam versus oral zuclopenthixol with lorazepam in the treatment of acute psychosis in emergency psychiatry: a prospective, comparative, open-label study.
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Oral risperidone with lorazepam versus oral zuclopenthixol with lorazepam in the treatment of acute psychosis in emergency psychiatry: a prospective, comparative, open-label study.

机译：口服利培酮与劳拉西m的口服利培酮相对于口服佐氯普他醇与劳拉西m的联合治疗在急诊精神病中的急性精神病：一项前瞻性，比较性，开放性研究。

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Acutely psychotic patients presenting as psychiatric emergencies with aggression or agitation are often administered conventional antipsychotics intramuscularly. However, patients view intramuscular administration as coercive, and conventional antipsychotics are often associated with adverse events. In this open study, consecutive adult patients presenting with an acute exacerbation of schizophrenia or other psychotic disorder were assigned to oral risperidone 2-6 mg/day (n = 48) or oral zuclopenthixol 20-50 mg/day (n = 27) for 7-14 days. Lorazepam (either oral or intramuscular) was administered to both groups as needed. Patients were assessed regularly until day 14 or discharge. Mean Positive And Negative Syndrome Scale (PANSS) aggression scores (sum of item scores on excitement, poor impulse control, hostility and uncooperativeness) decreased steadily and similarly in both groups; the mean changes from baseline were statistically significant at days 10 and 14 and at study end-point. The mean decreaseat study end-point in the PANSS component score for hostility was statistically significant in the risperidone group, but not in the zuclopenthixol group. Social Dysfunction and Aggression Scale aggression scores and Clinical Global Impression scores decreased significantly and similarly in both groups. Overall, 18.7% of patients showed minor extrapyramidal symptoms during the study, but only 16.7% of risperidone-treated patients, compared to 59.3% of zuclopenthixol-treated patients, received anti-parkinsonian medication (p < 0.001). Lorazepam was administered to all of the patients assigned to risperidone and to 89% of those assigned to zuclopenthixol. Oral risperidone plus lorazepam is a convenient, effective and well-tolerated alternative to conventional antipsychotics for the treatment of acute psychosis in emergency psychiatry.
机译：表现为侵略或激动的精神病紧急情况的急性精神病患者，通常在肌肉内进行常规抗精神病药物的治疗。然而，患者将肌肉内给药视为强制性的，而常规抗精神病药通常与不良事件相关。在这项开放性研究中，连续表现为精神分裂症或其他精神病急性加重的成年患者被分配口服利培酮2-6 mg /天（n = 48）或左氯哌噻吨20-50 mg / day（n = 27）， 7-14天。根据需要将劳拉西m（口服或肌内注射）用于两组。定期评估患者直到第14天或出院。两组的平均正负综合症量表（PANSS）攻击评分（兴奋，冲动控制不佳，敌意和不合作感的项目评分之和）稳定下降，两组相似。从基线的平均变化在第10天和第14天以及研究终点具有统计学意义。在利培酮组中，PANSS组分评分的敌意性研究终点的平均降低在统计学上是显着的，但在左氯哌噻吨组中没有统计学意义。社交功能障碍和攻击量表的攻击评分和临床总体印象评分在两组中均显着降低，且相似。总体而言，在研究期间有18.7％的患者显示出锥体外系症状，但是接受利培酮治疗的患者中只有16.7％接受了抗帕金森病药物治疗（相比之下，接受zuclopenthixol治疗的患者中只有59.3％）（p <0.001）。劳拉西m对所有分配给利培酮的患者和89％的zuclopenthixol进行治疗。口服利培酮和劳拉西m是常规抗精神病药的便捷，有效和耐受性强的替代品，用于治疗急诊精神病的急性精神病。

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