131022神分裂症依从要点.ppt

1000万 * * With the use of brain mapping algorithms, we detected striking anatomical profiles of accelerated gray matter loss in very early-onset schizophrenia; surprisingly, deficits moved in a dynamic pattern, enveloping increasing amounts of cortex throughout adolescence. Early-onset patients were rescanned prospectively with MRI, at 2-year intervals at three time points, to uncover the dynamics and timing of disease progression during adolescence. The earliest deficits were found in parietal brain regions, supporting visuospatial and associative thinking, where adult deficits are known to be mediated by environmental (nongenetic) factors. Over 5 years, these deficits progressed anteriorly into temporal lobes, engulfing sensorimotor and dorsolateral prefrontal cortices, and frontal eye fields. These emerging patterns correlated with psychotic symptom severity and mirrored the neuromotor, auditory, visual search, and frontal executive impairments in the disease. * * * * * Slide 94. All antipsychotics studied were associated with some degree of prolongation of the QTc interval. No patient had a QTc interval of 500 msec at any time during the study. The 95% confidence interval (CI) for the changes observed with ziprasidone overlapped only with haloperidol. There was no overlap between the lower 95% CI of the mean change associated with thioridazine and the upper 95% CI for any other agent studied.36 * Data presented show 95% confidence intervals for estimated weight change after 10 weeks of treatment with standard drug doses (estimated from a random effects model). Patients receiving placebo treatment lost an average of 0.74 kg (1.63 lb) and molindone was also associated with weight loss. For the remaining drugs, the degree of weight gain ranges from 0.04 kg (0.09 Ib) for ziprasidone to 4.45 kg (9.8 lb) for clozapine. Quetiapine weight change was estimated at 6 weeks, as 10 week data were not available. References: Allison DB, Mentore JL, Heo M et al. Antipsychot