遲發性運動障礙之精神病患藥物治療轉換為Aripiprazole之24週追蹤研究

Abstract

Background and Objective: Aripiprazole is a novel second generation antipsychotics, acting as a partial dopamine D2 receptor agonist, partial 5-HT1A agonist, and 5-HT2A antagonist. Previous studies on aripirazole for tardive dyskinesia (TD) treatment were limited and inconclusive. This study was aimed to examine the change of TD severity via switching antipsychotic treatment to aripiprazole in psychotic patients with a pre-existing TD. Methods: Thirty psychotic patients with neuroleptic-induced TD were recruited from a psychiatry teaching hospital in northern Taiwan from 2008 to 2010. These patients were cross-titrated of prior antipsychotics with aripiprazole and the severity of TD was assessed at baseline and at weeks 2, 4, 8, 12, 16, 20, and 24. TD was defined according to the research criteria in DSM-IV and was mainly evaluated by Abnormal Involuntary Movement Scale (AIMS). Results: The AIMS total scores significantly decreased from baseline to the end of the 24th week (7.17 ± 5.55). The significant improvement of AIMS total scores started to show up at week 2 (P<.0001) and the change remained significant over time (P<.0001). The greater severity of TD (OR: 1.35, 95% CI 1.04-1.76, P=.03) and a lower severity of parkinsonism (OR: 0.78, 95% CI 0.61-0.99, P=.04) at baseline was significantly associated with a positive treatment response (AIMS scores reduced ≧50%). Conclusion: Our findings implicated that aripiprazole can be a promising treatment for clinicians considering drug switch in patients with TD. Further large controlled trials are warranted.