Aripirazole이 정신병적 증상을 동반한 파킨슨병 환자의 정신증상 및 운동증상에 미치는 효과
The Effect of Aripiprazole on the Psychotic and Motor Symptoms in Parkinson Disease with Psychotic Feature
5
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives：We compared the effect of aripiprazole, risperidone and quetiapine on the change of psychotic and motor symptoms during 4 weeks in Parkinson disease patients with psychotic feature after levodopa treatment. Methods：Our study included both inpatients and outpatients. Of sixty patients, nineteen patients took risperidone, 21 patients took quetiapine and 20 patients took aripiprazole. Before administration of antipsychotic medications and 4weeks later, we evaluated psychotic symptoms and motor symptoms with Scale for the Assessment of Positive Symptoms(SAPS), Scale for the Assessment of Negative Symptoms(SANS) and motor part of Unified Parkinson’s Disease Rating Scale(UPDRS). Results：After 4 weeks of antipsychotic treatments, the positive symptoms measured by SAPS showed group difference. In the post hoc test, risperidone group and aripiprazole group showed more improvement in positive symptoms scale than quetiapine. The change of motor symptoms measured by UPDRS showed group difference. In the post hoc test, the quetiapine group showed less aggravation in motor symptoms than the risperidone and the aripiprazole group. The aripiprazole group showed less aggravation in motor symptom than risperidone group, but there was no statistical significance. Conclusion：Comparing the effectiveness of three antipsychotics(risperidone, quetiapine and aripiprazole) on the motor and psychotic symptoms in Parkinsonian patients who developed psychotic symptoms after taking levodopa, aripiprazole showed greater improvement in positive symptoms than quetiapine and similar effect with risperidone.
Abstract
Objectives：We compared the effect of aripiprazole, risperidone and quetiapine on the change of psychotic and motor symptoms during 4 weeks in Parkinson disease patients with psychotic feature after levodopa treatment. Methods：Our study included both inpatients and outpatients. Of sixty patients, nineteen patients took risperidone, 21 patients took quetiapine and 20 patients took aripiprazole. Before administration of antipsychotic medications and 4weeks later, we evaluated psychotic symptoms and motor symptoms with Scale for the Assessment of Positive Symptoms(SAPS), Scale for the Assessment of Negative Symptoms(SANS) and motor part of Unified Parkinson’s Disease Rating Scale(UPDRS). Results：After 4 weeks of antipsychotic treatments, the positive symptoms measured by SAPS showed group difference. In the post hoc test, risperidone group and aripiprazole group showed more improvement in positive symptoms scale than quetiapine. The change of motor symptoms measured by UPDRS showed group difference. In the post hoc test, the quetiapine group showed less aggravation in motor symptoms than the risperidone and the aripiprazole group. The aripiprazole group showed less aggravation in motor symptom than risperidone group, but there was no statistical significance. Conclusion：Comparing the effectiveness of three antipsychotics(risperidone, quetiapine and aripiprazole) on the motor and psychotic symptoms in Parkinsonian patients who developed psychotic symptoms after taking levodopa, aripiprazole showed greater improvement in positive symptoms than quetiapine and similar effect with risperidone.
참고문헌 (25)
- 김윤중, "파킨슨병의 병인", 대한신경과학회지, 22(5), pp.421~432 (2004), 대한신경과학회
- Golbe LI, "Autosomal dominant parkinsonism with benign course and typical Lewy-body pathology", Neurology, 43, pp.2222~2227 (1993)
- 고성범, "파킨슨병의 진단과 치료", 가정의학회지, 24, pp.1059~1068 (2003)
- Pavese N, "Clinical correlates of levodopa-induced dopamine release in Parkinson disease: a PET study", Neurology, 67, pp.1612~1617 (2006)
- Perry EK, "Cholinergic correlates of cognitive impairment in Parkinson's disease: comparisons with Alzheimer's disease", J Neurol Neurosurg Psychiatry, 48, pp.413~421 (1985)
- Dewey RB Jr, "Treatment of drug-induced psychosis with quetiapine and clozapine in Parkinson's disease", Neurology, 55, pp.1753~1754 (2000)
- Aarsland D, "Predictors of nursing home placement in Parkinson's disease: a population-based, prospective study", J Am Geriatr Soc, 48, pp.938~942 (2000)
- Breier A, "Olanzapine in the treatment of dopamimetic-induced psychosis in patients with Parkinson's disease", Biol Psychiatry, 52, pp.438~445 (2002)
- Ford B, "Risperidone in Parkinson's disease", Lancet, 3, pp.344~ (1994)
- Ondo WG, "Double-blind, placebo-controlled, unforced titration parallel trial of quetiapine for dopaminergic-induced hallucinations in Parkinson's disease", Mov Disord, 20, pp.958~963 (2005)
- Gomez-Esteban JC, "Use of ziprasidone in parkinsonian patients with psychosis", Clin Neuropharmacol, 28, pp.111~114 (2005)
- Meltzer HY, "The dopamine hypothesis of schizophrenia: a review", Schizophr Bull, 2, pp.19~76 (1976)
- Stahl SM, "Essential Psychopharmacology" (1996), Cambridge University Press
- Burris KD, "Aripiprazole, a novel antipsychotic, is a high-affinity partial agonist at human dopamine D2 receptors", J Pharmacol Exp Ther, 302, pp.381~389 (2002)
- butyloxy)-3,4-dihydro -2(1H)-quinolinone (OPC-14597) on prolactin release from the rat anterior pituitary gland, "J Pharmacol Exp Ther", 1996, 137~143
- butyloxy)-3,4-dihydro-2(1H)-qui nolinone (OPC-14597), a new putative antipsychotic drug with both presynaptic dopamine autoreceptor agonistic activity and postsynaptic D2 receptor antagonistic activity, "J Pharmacol Exp Ther", 1995, 329~336
- Jordan S, "The antipsychotic aripiprazole is a potent, partial agonist at the human 5-HT1A receptor", Eur J Pharmacol, 441, pp.137~140 (2002)
- Friedman JH, "Open-label flexible-dose pilot study to evaluate the safety and tolerability of aripiprazole in patients with psychosis associated with Parkinson's disease", Mov Disord, 21, pp.2078~2081 (2006)
- Fernandez HH, "Aripiprazole for drug-induced psychosis in Parkinson disease: preliminary experience", Clin Neuropharmacol, 27, pp.4~5 (2004)
- Gupta S, "Treatment of acute mania with aripiprazole in an older adult with noted improvement in coexisting Parkinson's disease", Prim Care Companion J Clin Psychiatry, 6, pp.50~51 (2004)
- Fahn S, "Memebers of the UPDRS development committee, unified Parkinson's disease rating scale macmillan, New York", ~ (1987)
- Andreasen NC, "The scale for the assessment of positive symptoms (SAPS)", pp.1984
- Andreasen NC, "The Scale for the Assessment of Negative Symptoms (SANS)", pp.1984
- Levy G, "Combined effect of age and severity on the risk of dementia in Parkinson's disease", Ann Neurol, 51, pp.722~729 (2002)
- Prohorov T, "The effect of quetiapine in psychotic Parkinsonian patients with and without dementia. An openlabeled study utilizing a structured interview", J Neurol, 253, pp.171~175 (2006)