정신분열병 또는 정신분열형장애를 가진 입원환자에서 Risperidone과 Olanzapine의 효과의 비교 : 6주간의 개방적 전향적 연구
A Comparative Effectiveness Study of Risperidone and Olanzapine in the Treatment of Inpatient of Schizophrenia or Schizophreniform Disorder : 6 Weeks, Open-Labelled, Prospective Study
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초록
본 연구는 olanzapine과 risperidone은 일반적 입원상황에서 정신분열병의 급성기 동안에 효과적으로 사용할 수 있으나, risperidone이 급성기 증상의 관해와 평균 재원일수의 단축에 있어 보다 나은 효과를 기대할 수 있고, 약물 비용에 있어서도 장점을 보여 비용-경제적인 측면에서는 risperidone이 장점을 가지고 있다는 것을 시사하고 있다. 하지만, 신경학적 － 167 － 점을 가지고 있고, 체중의 증가와 공복시 혈당의 변화 그리고 일반적인 부작용에서는 두 군간의 유의한 차이를 보이지 않아 정신분열병의 급성기 증상동안에 사용하는데 있어서의 안정성 측면에서는 olanzapine이 ris-peridone보다 장점을 가지고 있다는 것을 시사한다. 본 연구의 단점을 보완한 보다 광범위하고 장기간에 걸친 연구가 시행된다면 이 두 가지 약물의 특성과 장, 단점을 보다 자세히 파악할 수 있을 것으로 생각된다.
Abstract
Objectives ：Risperidone and olanzapine, which are atypical antipsychotics, are widely used in the treatment of schizophrenia as the 1st line drug, proving their effectiveness for both positive and negative symptoms. They also have many advantages even from the side effects. However, they show differences with the chemical structure and pharmacokinetics and they work differently to receptors. Researchers have studied the effect and side effect during the acute phase of schizophrenia as an open prospective study. Methods ：Forty subjects with DSM-IV schizophrenia or schizoaffective patients including 1) 1st onset schizophrenia patient, 2) patient who has been treated by the prior antipsychotics and not improved or even worse to be admitted again, were assigned to receive risperidone or olanzapine for 6 weeks. Psychopathology, adverse effect, weight change, fasting serum glucose, and drug cost were compared within and across groups. Results ：After 6 weeks later both treatment groups showed the significant decrease in PANSS positive, general psychopathology and total score while they did not show any significant difference between two groups. Risperidone group, however, showed the significant decrease in PANSS negative score, which olanzapine group did not. In terms of adverse effect risperidone group showed more extrapyramidal symptom than olanzapine group. Body weight rised significantly after 6weeks, but no significant difference between two treatment groups. There were no significant increase of fasting serum glucose level. Conclusions ：Risperidone and olanzapine are effective drugs which can be used during the acute phase of schizophrenia. Risperidone is expected to shorten the admission day and remission of the symptom of acute phase, while olanzapine is more advantage in a neurologic side effect than risperidone.