A Retrospective Comparison Study of Risperidone and Sulpiride for Outpatients with Dementia

回溯性比較Risperidone和Sulpiride對門診老年失智症患者之療效

10.29478/TJP.200706.0003

邱瑞祥(Juz-Hsiang Chiu)；陳志根(Chih-Ken Chen)；江淑娟(Chu-Chuan Chiang)；張景瑞(Ching-Jui Chang)；孫效儒(Hsiao-Ju Sun)

失智症 ； 抗精神病劑 ； risperidone ； sulpiride ； dementia ； antipsychotic ； risperidone ； sulpiride

台灣精神醫學

21卷2期（2007 / 06 / 01）

90 - 97

英文

目的：比較sulpiride與risperidone在治療老年失智症合併行為及精神症狀甲(BPSD)之療效與安全性。方法：本研究以2001年1月1日至2002年12月31日間至桃園療養院初診診斷符合BPSD之老年病患，且初次使用抗精神病劑為risperidone或sulpiride者為研究對象，回顧risperidone與sulpiride兩組病患初診起三個月內的全部病歷紀錄，比較兩組服藥後之療效、副作用、預約門診之遵從性與至中止治療之時間。結果：risperidone組36名，sulpiride組26名，兩組間無性別或年齡之差異。三個月內中止治療比率為50%，至中止治療之時間risperidone組為68.4±5.3(95%CI: 58.1-78.8)天，su1piride組為60.3±7.2(95%CI: 46.3-74.5)天。中止治療比率risperidone 組為41.7%，sulpiride組為61.5%，兩組於療效、副作用、或中止治療比率皆無顯著差異。此外，我們發現兩組病患副作用皆相當常見。結論：以risperidone或sulpiride治療老年BPSD患者並無顯著之療效或安全性的差異，但是藥物副作用與早期中止治療於兩組中皆常見。

Objective: To compare the effectiveness and safety of sulpiride and risperidone treatment in older patients with behavioral and psychological symptoms of dementia (BPSD). Methods: The medical records for the all BPSD patients who first attended Taoyuan Mental Hospital from January 1,2001 through December 31,2002, and who received risperidone or sulpiride were reviewed to obtain salient information. This included the effectiveness and side effects of the two drugs, compliance for follow-up appointments, and time to discontinuation of treatment in the 3 months after first prescription. The data for the BPSD patients treated with sulpiride or risperidone were then compared. Results: No significant differences in gender and age were demonstrated comparing the risperidone (n=36) and sulpiride treatment groups (n=26). The time to discontinuation was 68.4±5.3 (95%CI: 58.1-78.8) and 60.3±7.2 (95%CI: 46.3-74.5) days, respectively. The overall discontinuation rate during the 3 months of follow-up was 50%; 41.7% for the risperidone group and 61.5% for the sulpiride group. Moreover, no significant differences were found in discontinuation rate, treatment response, or side effects during the 3 months of follow up comparing the two groups. Further, we found that the observed side effects for both antipsychotic drugs were common in older patients with BPSD. Conclusion: No significant differences were demonstrated comparing therapeutic response or adverse effects between groups of BPSD patients stratified according to treatment with risperidone or sulpiride; however, adverse effects and early discontinuation were common in older patients irrespective of the drug.

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