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리스페리돈이나 올란자핀에서 지프라시돈으로 약물 교체한 정신분열병 환자의 주관적 삶의 질
송진옥(Jin Ok Song),이종훈(Jong Hun Lee),최태영(Tae Young Choi),이승재(Seung Jae Lee) 대한생물치료정신의학회 2009 생물치료정신의학 Vol.15 No.2
Objectives: The purpose of this study is to assess the subjective quality of life in stable but symptomatic patients with schizophrenia switched from risperidone or olanzapine to ziprasidone. And we investigated how the subjective quality of life is related with depression, drug attitude, drug satisfaction and psychopathology of schizophrenia. Methods: Twenty-three schizophrenic patients in 3 hospitals were switched to an 8-week, open label, flexible dose(80-160㎎/day) of ziprasidone. Psychiatric status was evaluated by Korean version of 4th Revision of Schizophrenia Quality of Life Scale(SQLS-R4K), Korean version of Calgary Depression Scale for Schizophrenia(KCDSS), Korean version of Drug Attitude Inventory(KDAI-10), Drug Satisfaction Questionaire(DSQ), Positive and Negative Syndrome Scale(PANSS), and Clinical Global Impression scale(CGI) at baseline, day 1, week 4 and week 8. Results: Subjective quality of life and depressive symptom were not improved significantly after switching to ziprasidone. Subjective quality of life was related significantly with depressive symptoms and drug attitude, but not drug satisfaction. Subjective quality of life correlated significantly with total scores and positive symptom scores in PANSS and CGI-S. Conclusion: This study suggests that the subjective quality of life of schizophrenia, who had treated by prior atypical antipsychotics, is not influenced significantly by switching to ziprasidone. Active management for depressive and positive symptoms, and drug side effect is recommended to improve patients' quality of life.
리스페리돈(Risperidone)을 투약 중인 정신분열병 환자에서 지프라시돈(Ziprasidone)으로 교체 투약 시 보이는 임상적 및 대사적 이득에 대한 전향적 개방 연구
이종훈(Jong Hun Lee),송진옥(Jin Ok Song),이승재(Seung Jae Lee),정성원(Sung Won Jung),구본훈(Bon Hoon Koo),이광헌(Kwang Heun Lee) 대한생물치료정신의학회 2009 생물치료정신의학 Vol.15 No.1
Objectives:The purpose of this study was to assess clinical effectiveness and metabolic benefits by switching from risperidone to ziprasidone in chronic stable schizophrenic patients. Methods:A total of 19 patients taking risperidone were switched to a 12-week, open label, flexible dose(80- 160㎎/day) of ziprasidone. Current psychiatric status was evaluated by Positive and Negative Syndrome Scale(PANSS), Clinical Global Impression(CGI), and Global Assessment of Functioning(GAF). Drug induced abnormal movements were assessed using various scales. Laboratory tests including lipid profiles, HbA1c, fasting plasma glucose and electrocardiography were carried out. Results:Of the 19 enrolled patients, 14 patients(73.7%) completed the study. Mean daily dose were 6.1±2.0㎎ for risperidone at the baseline and 123.1±8.1㎎ for ziprasidone at the end point of the study. Significant improvements were found on PANSS negative subscale scores(p<.05), with trends towards improved positive and psychopathology subscale scores. Among metabolic parameters, mean total cholesterol, triglyceride, and free fatty acid showed significant improvements(all ps<.05). In line with these findings, mean body weight and hip size significantly decreased from baseline(each p<.05). Regarding tolerability, frequency and severity of abnormal movements were not significantly different between two drugs. The ECG results showed no significant change from baseline in the QTc interval. Conclusion:Our findings supported the use of ziprasidone as a good option for the treatment of stable yet partially resolved outpatients with schizophrenia who has been taking risperidone continually, with benefits in efficacy particularly negative symptoms, reduction of body weight as well as hip size, and improvements in metabolic risk factors.