리스페리돈(Risperidone)을 투약 중인 정신분열병 환자에서 지프라시돈(Ziprasidone)으로 교체 투약 시 보이는 임상적 및 대사적 이득에 대한 전향적 개방 연구

Abstract

Objectives：The purpose of this study was to assess clinical effectiveness and metabolic benefits by switching from risperidone to ziprasidone in chronic stable schizophrenic patients. Methods：A total of 19 patients taking risperidone were switched to a 12-week, open label, flexible dose(80- 160㎎/day) of ziprasidone. Current psychiatric status was evaluated by Positive and Negative Syndrome Scale(PANSS), Clinical Global Impression(CGI), and Global Assessment of Functioning(GAF). Drug induced abnormal movements were assessed using various scales. Laboratory tests including lipid profiles, HbA1c, fasting plasma glucose and electrocardiography were carried out. Results：Of the 19 enrolled patients, 14 patients(73.7%) completed the study. Mean daily dose were 6.1±2.0㎎ for risperidone at the baseline and 123.1±8.1㎎ for ziprasidone at the end point of the study. Significant improvements were found on PANSS negative subscale scores(p＜.05), with trends towards improved positive and psychopathology subscale scores. Among metabolic parameters, mean total cholesterol, triglyceride, and free fatty acid showed significant improvements(all ps＜.05). In line with these findings, mean body weight and hip size significantly decreased from baseline(each p＜.05). Regarding tolerability, frequency and severity of abnormal movements were not significantly different between two drugs. The ECG results showed no significant change from baseline in the QTc interval. Conclusion：Our findings supported the use of ziprasidone as a good option for the treatment of stable yet partially resolved outpatients with schizophrenia who has been taking risperidone continually, with benefits in efficacy particularly negative symptoms, reduction of body weight as well as hip size, and improvements in metabolic risk factors.