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首页> 外文期刊>Human psychopharmacology: clinical and experimental >Dosage finding and outcome in the treatment of schizophrenic inpatients with amisulpride. Results of a drug utilization observation study.
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Dosage finding and outcome in the treatment of schizophrenic inpatients with amisulpride. Results of a drug utilization observation study.

机译：剂量发现和治疗结果醇和四种精神分裂症患者。观察药物利用研究的结果。

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OBJECTIVES: Amisulpride is an unique neuroleptic drug insofar as it has a dual pharmacodynamic effect. At low doses it blocks selectively presynaptic autoreceptors, and at high doses it blocks postsynaptic D(2)/D(3) receptors. This allows the dosage to be adjusted and the treatment tailored to various clinical situations. It is unknown whether this pharmacological property has any bearing for routine treatment. The questions are: which dosages of amisulpride are chosen by physicians in the treatment of schizophrenic inpatients and does this dosage handling deviate from prescription guidelines?; which factors can explain dosage selection, and what is the treatment outcome with different dosages? The study pertains to drug management and dosage finding as principal factors in explaining positive and negative medication results. METHODS: In a drug utilization observation study the prescribing of amisulpride for 811 schizophrenic inpatients from 240 psychiatric hospitals was monitored for 8 weeks. Standardized assessment included dosage, the positive and negative symptom scale (PANSS), the clinical global impression rating (CGI), the patients' subjective reaction to amisulpride, psychosocial functioning, EPS and other adverse events. The mean observation period was 49 days. RESULTS: The mean initial daily dose of amisulpride was 361 mg/day. The mean daily dose at day 56 was on average 550 (SD 266) mg/d, ranging from 100 mg to 1600 mg. 17.9% of patients received a maximum dose up to 399 mg/d, 48.1% between 400 and 799 mg/d, and 25.5% 800 mg/d and higher. Higher doses were preferably prescribed for males, patients with involuntary admission, patients with paranoid schizophrenia with acute exacerbation, high CGI and high PANSS-positive scores. Patients with higher doses of amisulpride at the same time received higher rates of additional other neuroleptic drugs. Higher doses yield better results in very severe cases. CONCLUSIONS: Prescribed dosages were in the lower range of what is recommended for acute cases. Dosage was significantly influenced by the severity of the illness. Polypharmacy was the rule rather than the exception. Efficacy rates under conditions of routine care were similar to the results from controlled clinical trials, which speaks for their generalizability. Very severe cases profit from higher doses.
机译：醇和四种目标:是一个独特的安定药物,因为它有一个双重药效学的效果。突触前受体,在高剂量块突触后D (2) / D(3)受体。允许剂量和调整根据不同的临床治疗的情况。药理性质有任何轴承常规治疗。由医生醇和四种剂量的选择治疗精神分裂症住院病人这剂量处理偏离吗处方指南吗?;解释剂量选择,是什么治疗效果与不同剂量?研究与药物管理和剂量寻找解释的主要因素积极的和消极的治疗结果。方法:观察药物利用研究醇和四种的处方为811从240年精神精神分裂症住院病人医院监控8周。评估包括用量、积极和阴性症状量表(PANSS),临床全球印象评级(CGI),病人的醇和四种的主观反应,心理功能,每股收益和其他不良事件。观察期间是49天。醇和四种意思的初始剂量是361年毫克/天。266年平均550 (SD) mg / d,从100毫克1600毫克。剂量399毫克/天,从400年到799年的48.1%毫克/天,25.5% 800 mg / d和更高。最好是规定了男性,患者自愿住院患者偏执型精神分裂症急性恶化,高CGI和高PANSS-positive分数。醇和四种高剂量的在同一时间获得较高的额外的其他安定药。导致很严重的病例。低剂量的范围的规定什么是推荐用于急性病例。显著影响的严重性疾病。例外。日常保健是类似的结果控制临床试验,说明了他们的普遍性。从更高的剂量。

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