Zuclopenthixol醋酸对急性精神分裂症和类似的严重的精神疾病。

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Jayakody K,吉布森RC, Kumar Gunadasa年代

Zuclopenthixol醋酸对急性精神分裂症和类似的严重的精神疾病。

科克伦数据库系统启2012年4月18日;4:CD000525。cd000525.pub3 doi: 10.1002/14651858.。

PubMed ID
22513898 (在PubMed
]
文摘

背景:药物用于急性精神病学侵略必须有快速的效果,低频率的管理和低水平的不利影响。醋酸Zuclopenthixol据说这些性质。目的:评估的临床效果乙酸zuclopenthixol管理急性攻击或暴力被认为是由于严重的精神疾病,相比其他药物用于治疗类似的条件。必威国际app搜索方法:我们搜查了科克伦精神分裂症组试验注册(2011年7月)。我们通过文献搜索和补充个人联系作者和相关的制药公司。必威国际app选择标准:所有随机临床试验涉及人们认为有严重精神疾病比较zuclopenthixol醋酸与其他药物。数据收集和分析:两个独立审查作者提取和反复核对数据。我们计算固定效果相对风险(RR)和95%置信区间为二分数据(CI)。我们通过意向处理分析。我们使用的意思是连续变量(MD)的差异。 MAIN RESULTS: We found no data for the primary outcome, tranquillisation. Compared with haloperidol, zuclopenthixol acetate was no more sedating at two hours (n = 40, 1 RCT, RR 0.60, 95% CI 0.27 to 1.34). People given zuclopenthixol acetate were not at reduced risk of being given supplementary antipsychotics (n = 134, 3 RCTs, RR 1.49, 95% CI 0.97 to 2.30) although additional use of benzodiazepines was less (n = 50, 1 RCT, RR 0.03, 95% CI 0.00 to 0.47). People given zuclopenthixol acetate had fewer injections over seven days compared with those allocated to haloperidol IM (n = 70, 1 RCT, RR 0.39, 95% CI 0.18 to 0.84, NNT 4, CI 3 to 14). We found no data on more episodes of aggression or harm to self or others. One trial (n = 148) reported no significant difference in adverse effects for people receiving zuclopenthixol acetate compared with those allocated haloperidol at one, three and six days (RR 0.74, 95% CI 0.43 to 1.27). Compared with haloperidol or clotiapine, people allocated zuclopenthixol did not seem to be at more risk of a range of movement disorders (< 20%). Three studies found no difference in the proportion of people getting blurred vision/dry mouth (n = 192, 2 RCTs, RR at 24 hours 0.90, 95% CI 0.48 to 1.70). Similarly, dizziness was equally infrequent for those allocated zuclopenthixol acetate compared with haloperidol (n = 192, 2 RCTs, RR at 24 hours 1.15, 95% CI 0.46 to 2.88). There was no difference between treatments for leaving the study before completion (n = 522, RR 0.85, 95% CI 0.31 to 2.31). One study reported no difference in adverse effects and outcome scores, when high dose (50-100 mg/injection) zuclopenthixol acetate was compared with low dose (25-50 mg/injection) zuclopenthixol acetate. AUTHORS' CONCLUSIONS: Recommendations on the use of zuclopenthixol acetate for the management of psychiatric emergencies in preference to 'standard' treatment have to be viewed with caution. Most of the small trials present important methodological flaws and findings are poorly reported. This review did not find any suggestion that zuclopenthixol acetate is more or less effective in controlling aggressive acute psychosis, or in preventing adverse effects than intramuscular haloperidol, and neither seemed to have a rapid onset of action. Use of zuclopenthixol acetate may result in less numerous coercive injections and low doses of the drug may be as effective as higher doses. Well-conducted pragmatic randomised controlled trials are needed.

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