- 期刊
比較Haloperidol, Remoxipride與Sulpiride在精神分裂病患者引起激乳素血清濃度不同反應
Difference in Prolaction Response of Schizophrenic Patients to Equivalent Doses of Haloperidol, Remoxipride and Sulpiride
摘要
臨床上，許多精神分裂病患者服用抗精神藥物治療，此種藥物會促使激乳素的血清濃度昇高，導致性功能失調。本研究將27名精神分裂病個案隨機抽樣分成3組，停藥2週，分別以固定劑量之haloperidol, remoxipride與sulpiride 3種藥物治療（haloperidol 20mg, remoxipride 450mg與sulpiride 1800mg）。住院同時，固定1名資深精神科醫師利用Nancy C. Andreasen的正性及負性症狀量表（SAPS及SANS）把精神分裂病個案分出亞型，再由另1名資深精神科醫師以簡短精神症狀量表（BPRS），每週1次評估治療效果。此外每位患者每週抽血1次監測激乳素血清濃度。 統計方法採Zegar所提出的Generalized Esimating Equation-I（GEE-I）來處理自變項和依變項。結果顯示：3種藥物均會引起激乳素血清濃度昇高，尤以sulpiride 引起的激乳素血清濃度最高；激乳素的反應與亞型精神分裂病之間，在統計數字上看來並未見有意義的差異；且激乳素昇高與否和臨床療效、現在年齡以及發病年齡亦無相關性；但卻在性別上有影響。此研究顯示女性患者服用抗精神藥物後，比男性更易引起激乳素血清濃度昇高。由以上結果，本研究建議治療者對於精神分裂病的女性病患，在選擇抗精神藥物時，必須更加審慎的使用sulpiride。
關鍵字
無資料並列摘要
Clinically, most of the schizophrenics usually are treated with neuroleptics. This kind of medicine increases the prolactin level in serum that causes sexual dysfunction. In this study, 27 schizophrenics were divided into three groups. After discontinuation of taking the prior medicine for more than two weeks, subjects were treated respectively with fixed doses of haloperidol (20mg), remoxipride (450mg), and sulpiride (1800mg). During hospitalization, an assigned senior resident used Nancy O. Andresen’s Scale for the assessment of Positive Symptoms (SAPS) and Negative Symptoms (SANS) as tools to categorize schizophrenic subjects into subtypes, and another senior resident evaluated the effectiveness of the treatment once a week with the Brief Psychiatric Rating Sacle (BPRS). Prolactin level in serum was monitored weekly with fluorescent assay. The Generalized Estimating Equation-I was utilized to analyze the deta. The results show that all of the three medicines cause elevation of prolactin level in serum, and sulpiride causes the highest elevation of prolactin level in this study. There is no difference between the subtype of schizophrenia and prolactin reaction. There is also no correlation between the degree of elevation in prolactin and the effectiveness of treatment: However, there is a statistically significant difference in the serum levels between genders. After being treated with antipsychotics, female patients are more likely than male patietns to have an elevated prolactin serum level. In conclusion, this study suggests that physicians should be more cautious while treating female psychotic patients with sulpiride.