Clinical Evaluation of A Novel Antipsychotic Drug, Risperidone, in Schizophrenia
| Autor: | Hsiang-Chen, Chang, 張祥成 |
|---|---|
| Rok vydání: | 1999 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 87 Schizophrenia is a group of illness of unknown origin that occurred in 1% of the adult population in most countries in which surveys have been conducted. The economic and social cost is considerable, as approximately 40% of all hospitalized psychiatric patients suffer from schizophrenia and related disorders, and that continues to place a large social and economic burden on individual and society. Schizophrenia usually begins during adolescence or young adulthood and is characterized by spectrum of symptoms that typically include disordered thought, social withdrawal, hallucinations (both aural and visual), paranoia and bizarre behavior. These symptoms are categorized as "positive"(e.g. hallucinations and paranoia behavior) and "negative"(e.g. social withdrawal and apathy). The pharmacological management of schizophrenia had played a major role in limiting the disintegration of the personality of schizophrenic patient. Although conventional antipsychotics are very effective to alleviate positive symptoms of schizophrenia, they have several limitations. The most important is a poor safety profile, notably the occurrence of EPS at therapeutic doses. In addition, conventional agents have relatively weak activity against negative symptoms. This is particularly important because negative symptoms are more associated than positive symptoms with poor long-term vocational and social outcomes. Finally, substantial proportions of patients are refractory to treatment with the older agents, which also have the potential to cause tardive dyskinesia. The atypical antipsychotic drug, risperidone combine, the known antipsychotic effects of dopaminergic receptor antagonism (seen in classical antipsychotics such as chlorpromazine and haloperidol) and serotoninergic receptor antagonism. On the basis of its pharmacology, risperidone can be predicted to have good therapeutic efficacy and a low incidence of extrapyramidal adverse effects. Since risperidone is a novel antipsychotic drug to be present marketing in Taiwan. We hope to comprehend the clinical efficacy and related side effects of risperidone. Thus, this study was to assess risperidone on the clinical efficacy of positive and negative symptoms, EPS and other related side effects on risperidone in schizophrenic patients in a 300-bed psychiatric hospital in the middle Taiwan. A retrospective drug utilization(D.U.E.) evaluation was conducted via computer-based data and medical records. There were 46 patients (include inpatients and outpatients) who had ever been prescribed Risperidone during June 1st 1997 to December 31st 1997. According to the criteria of D.U.E., 26 patients (including 15 outpatients and 11 inpatients whose age was between twenty one to sixty three years old) were selected for a evaluation of 12 weeks period. The usage guideline for evaluation of the effects of risperidone was defined by referring to literatures and specialists'' opinions. The average dose of risperidone for outpatients was 3.87mg daily and for inpatients was 6.57mg daily. The results of this study show that clinical improvement of risperidone on positive symptoms at the study end point were shown by 53.33% of the outpatients and 36.37% of the inpatients, respectively. In addition, clinical improvement of risperidone on negative symptoms were shown by 33.33% of the outpatients and by 27.28% of the inpatients, respectively. The incidence of extrapyramidal side effects in the study was low as placebo, which referred from some earlier literatures. The other side effects of risperidone excepted EPS in this study were mild. However, the occurrence of insomnia and some cardiovascular side effects in elder patients had to be noticed. On the other hand, no abnormal results of laboratory test were recorded in any of risperidone-treated patients. According to these findings, it is concluded that risperidone is an effective drug for improving both positive and negative symptoms of schizophrenia with a low incidence of adverse effects. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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