- 期刊
Tolerability and Efficacy of Amisulpride in Elderly Chronic Psychotic Patients: A 12-week Open-labeled Study
老年精神病患者使用Amisulpride之耐受性與療效之評估：十二週之開放性研究
摘要
前言：隨著老年精神病患者的盛行率及發生率增加，兼顧耐受性及療效的治療為目前關注的焦點。Amisulpride之藥物顯示在治療精神分裂症患者的療效與傳統抗精神病藥物及新一代抗精神病藥物相當，且僅具較少的椎體外症候群及代謝症候群之副作用，故本研究探討老年慢性精神病患者使用十二週Amisulpride後耐受性及療效評估。 方法：本研究為追蹤及開放性試驗，納入六十歲以上之符合DSM-IV診斷之老年精神病患。共45位進入研究，34位完成研究，比較使用amisulpride 50-800 mg/day其前後活性與負性症狀評量表(PANSS)、抗精神病藥物相關之副作用量表及臨床血液生化學檢查等變化。 結果：PANSS 總分及負性症狀分數改善具統計上意義，對於抗精神病藥物相關之副作用量表方面無顯著改變，臨床生化值亦無變化，體重降低具統計意義，泌乳激素升高具統計意義，無其他臨床重大副作用。 結論：Amisulpride在老年精神病患之治療具耐受性及相當療效。
並列摘要
Objectives: To evaluate the tolerability and efficacy of treatment with amisulpride in elderly patients with chronic psychosis. Methods: This study recruited patients of both sexes aged 60 years or older, meeting the DSM-IV criteria for psychotic disorders, and reporting psychotic symptoms severe enough to require antipsychotic medications. Subjects were selected from residents in a chronic mental hospital, who, after being treated with antipsychotics for years, were switched to amisulpride with flexible dose for twelve weeks. Safety assessment involving adverse event reporting, physical examination, ECG, laboratory tests and extrapyramidal symptoms were evaluated or monitored. Efficacy parameters were based on changes in score on the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity (CGI-S). Results: 45 patients (mean age: 66.7±5.7 years) were recruited with 34 completing the 12-week study. 11 patients discontinued the study due to the emergence of acute psychotic episode. Mean dosage of antipsychotics in baseline is 340.4±292.2 mg, and mean dosage of amisulpride at end point was 365.2±204.8 mg/day. The PANSS total score mildly decreased at the end of study without significant difference. A significant improvement in the negative symptom domain of PANSS was noted at the end of study. At study endpoint, no significant baseline-to-endpoint differences were observed on total and subscales of side effect parameters. No significant changes of biochemical data, such as fasting glucose, cholesterol, and triglyceride between baseline and end point was found except decrease in body weight. Conclusion: Amisulpride is generally well tolerated in elderly patients with psychosis and shows some efficacy in the study population.