{"title":"用去甲肾上腺素再摄取抑制剂治疗男性精神分裂症患者的阴性症状","authors":"S. Shafti, Mohammad Jafarabad, Reza Azizi","doi":"10.5455/BCP.20150511053723","DOIUrl":null,"url":null,"abstract":"ABS TRACT: Tackling negative symptoms in male patients with schizophrenia using a norepinephrine reuptake inhibitor Objective: Placebo-controlled trials of antidepressants in patients with schizophrenia with prominent negative symptoms usually have presented contradictory results. Reboxetine is a norepinephrine reuptake inhibitor (NRI) antidepressant. Preceding studies regarding possible advantageous effects of reboxetine on deficit symptoms of schizophrenia, too, have resulted in inconsistent outcomes. The present study again assesses the effectiveness of reboxetine as an adjunctive treatment in a group of patients with schizophrenia with prominent negative symptoms. Method: Fifty male inpatients meeting the diagnosis of schizophrenia were enrolled into a 12-week parallel group, double-blind study with random assignment to reboxetine (n=25 patients) or placebo (n=25 patients). Inclusion criterion, in addition to the diagnosis of schizophrenia, was the existence of obvious negative symptoms for a duration of at least two years. Cases with existing co-morbidities like major depressive disorder or diagnosis of schizoaffective disorder or cases that were prescribed long-acting depot or atypical antipsychotics, antidepressants, or lithium were excluded. The Scale for Assessment of Negative Symptoms (SANS) was used as the primary outcome measure. Scale for Assessment of Positive Symptoms (SAPS), Simpson Angus Scale (SAS), Hamilton Rating Scale for Depression (HAM-D) and Mini-Mental Status Examination (MMSE) were used for comparison of the intervening parameters in this study. Duration of the assessment was twelve weeks, and the patients were assessed at baseline (week 0), and at the end of the 4 th , 8 th , and 12 th week by SANS and SAPS. Treatment efficacy was analyzed by t test and repeated-measures analysis of variance (ANOVA). Statistical significance was defined as a 2-sided p value ≤0.05. Results: According to our findings, 76% of the patients in the target group showed some positive response to reboxetine, in comparison with 24% in the control group (p<0.01). Mean total score of SANS in the reboxetine group decreased significantly from 79.94±1.20 to 74.23±4.07 (p<0.0001) at the end of the study, while such an improvement was not significant in the placebo group with a decrement from 80.42±2.46 to 79.08±5.83 (p<0.29). Between-group analysis, as well, showed that the mean total score of SANS in the reboxetine group, in comparison with the control group, improved significantly at 8 and 12 weeks (p<0.03 and p<0.01 respectively). Repeated-measures analysis of variance (ANOVA) showed significant improvement of SANS in the reboxetine group (p<0.02), and also a significant difference in this regard between groups (p<0.001). Changes of SAPS were insignificant in both groups. Effect size (ES) analysis for changes of SANS at the end of assessment indicated a large improvement with reboxetine (Cohen’s d = 2.91). Post-hoc power analysis showed a power equal to 0.53 (intermediary) for this trial. Conclusion: Reboxetine, as adjuvant to haloperidol, may have helpful effects on negative symptoms of schizophrenia.","PeriodicalId":17852,"journal":{"name":"Klinik Psikofarmakoloji Bulteni-bulletin of Clinical Psychopharmacology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Tackling Negative Symptoms in Male Patients with Schizophrenia Using a Norepinephrine Reuptake Inhibitor\",\"authors\":\"S. Shafti, Mohammad Jafarabad, Reza Azizi\",\"doi\":\"10.5455/BCP.20150511053723\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"ABS TRACT: Tackling negative symptoms in male patients with schizophrenia using a norepinephrine reuptake inhibitor Objective: Placebo-controlled trials of antidepressants in patients with schizophrenia with prominent negative symptoms usually have presented contradictory results. Reboxetine is a norepinephrine reuptake inhibitor (NRI) antidepressant. Preceding studies regarding possible advantageous effects of reboxetine on deficit symptoms of schizophrenia, too, have resulted in inconsistent outcomes. The present study again assesses the effectiveness of reboxetine as an adjunctive treatment in a group of patients with schizophrenia with prominent negative symptoms. Method: Fifty male inpatients meeting the diagnosis of schizophrenia were enrolled into a 12-week parallel group, double-blind study with random assignment to reboxetine (n=25 patients) or placebo (n=25 patients). Inclusion criterion, in addition to the diagnosis of schizophrenia, was the existence of obvious negative symptoms for a duration of at least two years. Cases with existing co-morbidities like major depressive disorder or diagnosis of schizoaffective disorder or cases that were prescribed long-acting depot or atypical antipsychotics, antidepressants, or lithium were excluded. The Scale for Assessment of Negative Symptoms (SANS) was used as the primary outcome measure. Scale for Assessment of Positive Symptoms (SAPS), Simpson Angus Scale (SAS), Hamilton Rating Scale for Depression (HAM-D) and Mini-Mental Status Examination (MMSE) were used for comparison of the intervening parameters in this study. Duration of the assessment was twelve weeks, and the patients were assessed at baseline (week 0), and at the end of the 4 th , 8 th , and 12 th week by SANS and SAPS. Treatment efficacy was analyzed by t test and repeated-measures analysis of variance (ANOVA). Statistical significance was defined as a 2-sided p value ≤0.05. Results: According to our findings, 76% of the patients in the target group showed some positive response to reboxetine, in comparison with 24% in the control group (p<0.01). Mean total score of SANS in the reboxetine group decreased significantly from 79.94±1.20 to 74.23±4.07 (p<0.0001) at the end of the study, while such an improvement was not significant in the placebo group with a decrement from 80.42±2.46 to 79.08±5.83 (p<0.29). Between-group analysis, as well, showed that the mean total score of SANS in the reboxetine group, in comparison with the control group, improved significantly at 8 and 12 weeks (p<0.03 and p<0.01 respectively). Repeated-measures analysis of variance (ANOVA) showed significant improvement of SANS in the reboxetine group (p<0.02), and also a significant difference in this regard between groups (p<0.001). Changes of SAPS were insignificant in both groups. Effect size (ES) analysis for changes of SANS at the end of assessment indicated a large improvement with reboxetine (Cohen’s d = 2.91). Post-hoc power analysis showed a power equal to 0.53 (intermediary) for this trial. Conclusion: Reboxetine, as adjuvant to haloperidol, may have helpful effects on negative symptoms of schizophrenia.\",\"PeriodicalId\":17852,\"journal\":{\"name\":\"Klinik Psikofarmakoloji Bulteni-bulletin of Clinical Psychopharmacology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2015-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Klinik Psikofarmakoloji Bulteni-bulletin of Clinical Psychopharmacology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5455/BCP.20150511053723\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Klinik Psikofarmakoloji Bulteni-bulletin of Clinical Psychopharmacology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5455/BCP.20150511053723","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 1
摘要
ABS摘要:应用去甲肾上腺素再摄取抑制剂治疗男性精神分裂症患者的阴性症状目的:在具有明显阴性症状的精神分裂症患者中使用抗抑郁药的安慰剂对照试验通常会出现相互矛盾的结果。瑞波西汀是一种去甲肾上腺素再摄取抑制剂(NRI)抗抑郁药。先前关于瑞波西汀对精神分裂症缺陷症状可能有利作用的研究也导致了不一致的结果。本研究再次评估了利波西汀作为一组有明显阴性症状的精神分裂症患者的辅助治疗的有效性。方法:将50例诊断为精神分裂症的男性住院患者纳入为期12周的平行双盲研究,随机分配至瑞博西汀(n=25例)或安慰剂(n=25例)。除精神分裂症诊断外,纳入标准为存在明显阴性症状至少两年。排除存在共病的病例,如重度抑郁症或诊断为分裂情感性障碍,或处方长效长效抗精神病药或非典型抗精神病药、抗抑郁药或锂盐的病例。阴性症状评估量表(SANS)被用作主要结果测量。采用阳性症状评定量表(SAPS)、辛普森安格斯量表(SAS)、汉密尔顿抑郁评定量表(HAM-D)和简易精神状态检查量表(MMSE)进行干预参数比较。评估时间为12周,患者在基线(第0周)、第4周、第8周和第12周末分别接受SANS和SAPS评估。采用t检验和重复测量方差分析(ANOVA)分析治疗效果。统计学显著性定义为双侧p值≤0.05。结果:根据我们的研究结果,目标组中76%的患者对瑞波西汀有一定的积极反应,而对照组为24% (p<0.01)。研究结束时,瑞博西汀组SANS的平均总分从79.94±1.20显著下降到74.23±4.07 (p<0.0001),而安慰剂组的改善不显著,从80.42±2.46下降到79.08±5.83 (p<0.29)。组间分析显示,与对照组相比,瑞波西汀组的SANS平均总分在8周和12周显著提高(p<0.03和p<0.01)。重复测量方差分析(ANOVA)显示,瑞波西汀组SANS有显著改善(p<0.02),两组间差异有显著性(p<0.001)。两组SAPS变化均不显著。评估结束时SANS变化的效应量(ES)分析表明,瑞博西汀有很大的改善(Cohen’s d = 2.91)。事后功效分析显示该试验的功效为0.53(中间值)。结论:利波西汀辅助氟哌啶醇治疗精神分裂症阴性症状可能有积极作用。
Tackling Negative Symptoms in Male Patients with Schizophrenia Using a Norepinephrine Reuptake Inhibitor
ABS TRACT: Tackling negative symptoms in male patients with schizophrenia using a norepinephrine reuptake inhibitor Objective: Placebo-controlled trials of antidepressants in patients with schizophrenia with prominent negative symptoms usually have presented contradictory results. Reboxetine is a norepinephrine reuptake inhibitor (NRI) antidepressant. Preceding studies regarding possible advantageous effects of reboxetine on deficit symptoms of schizophrenia, too, have resulted in inconsistent outcomes. The present study again assesses the effectiveness of reboxetine as an adjunctive treatment in a group of patients with schizophrenia with prominent negative symptoms. Method: Fifty male inpatients meeting the diagnosis of schizophrenia were enrolled into a 12-week parallel group, double-blind study with random assignment to reboxetine (n=25 patients) or placebo (n=25 patients). Inclusion criterion, in addition to the diagnosis of schizophrenia, was the existence of obvious negative symptoms for a duration of at least two years. Cases with existing co-morbidities like major depressive disorder or diagnosis of schizoaffective disorder or cases that were prescribed long-acting depot or atypical antipsychotics, antidepressants, or lithium were excluded. The Scale for Assessment of Negative Symptoms (SANS) was used as the primary outcome measure. Scale for Assessment of Positive Symptoms (SAPS), Simpson Angus Scale (SAS), Hamilton Rating Scale for Depression (HAM-D) and Mini-Mental Status Examination (MMSE) were used for comparison of the intervening parameters in this study. Duration of the assessment was twelve weeks, and the patients were assessed at baseline (week 0), and at the end of the 4 th , 8 th , and 12 th week by SANS and SAPS. Treatment efficacy was analyzed by t test and repeated-measures analysis of variance (ANOVA). Statistical significance was defined as a 2-sided p value ≤0.05. Results: According to our findings, 76% of the patients in the target group showed some positive response to reboxetine, in comparison with 24% in the control group (p<0.01). Mean total score of SANS in the reboxetine group decreased significantly from 79.94±1.20 to 74.23±4.07 (p<0.0001) at the end of the study, while such an improvement was not significant in the placebo group with a decrement from 80.42±2.46 to 79.08±5.83 (p<0.29). Between-group analysis, as well, showed that the mean total score of SANS in the reboxetine group, in comparison with the control group, improved significantly at 8 and 12 weeks (p<0.03 and p<0.01 respectively). Repeated-measures analysis of variance (ANOVA) showed significant improvement of SANS in the reboxetine group (p<0.02), and also a significant difference in this regard between groups (p<0.001). Changes of SAPS were insignificant in both groups. Effect size (ES) analysis for changes of SANS at the end of assessment indicated a large improvement with reboxetine (Cohen’s d = 2.91). Post-hoc power analysis showed a power equal to 0.53 (intermediary) for this trial. Conclusion: Reboxetine, as adjuvant to haloperidol, may have helpful effects on negative symptoms of schizophrenia.