Background Over 10 million Chinese are affected by schizophrenia. The annual cost of schizophrenia in China was estimated at US$2586 per patient.Aims The study has two aims:(1) to conduct a targeted literature review ...Background Over 10 million Chinese are affected by schizophrenia. The annual cost of schizophrenia in China was estimated at US$2586 per patient.Aims The study has two aims:(1) to conduct a targeted literature review of the economic literature on oral ziprasidone in China, and(2) to develop an inpatient economic model that compared the cost of intramuscular ziprasidone with other regimens including electroconvulsive therapy(ECT) for the management of acute agitation in patients with schizophrenia from a hospital's perspective in China.Methods A targeted literature review was conducted using PubMed and the Chinese literature databases for studies published between January 2007 and December2017. Studies that assessed costs associated with oral ziprasidone treatment for schizophrenia in China were summarised. In the inpatient economic model,cost measures included hospital room and board,antipsychotics,ECT and medications for the management of extrapyramidal symptoms(EPS). Input for standard antipsychotic regimens and unit cost were obtained from the literature. Hospital length of stay(LOS), utilisation of ECT and incidence of EPS were derived from the literature and supplemented/validated with a survey of psychiatrists in China. Cost was presented in 2017 Chinese yuan.Results The average estimated LOS was 29 days with ziprasidone, 33 days with risperidone+benzodiazepine,32 days with olanzapine, 35 days with haloperidol and 29 days with ECT. The cost of antipsychotics was $1260 with ziprasidone, $137 with risperidone+benzodiazepine, $913 with olanzapine and $210 with haloperidol; ECT treatment costs $785. The base-case analysis suggested that higher antipsychotic cost with ziprasidone was offset by savings with shorter LOS. Using intramuscular ziprasidone for acute management was associated with a total cost of $11157, the lowest among all antipsychotic regimens($11 424 with risperidone+benzodiazepine, $11 711 with olanzapine and $11 912 with haloperidol) and slightly higher than ECT($10 606). The cost of antipsychotics and ECT accounted for 1 %-11 % of the total cost. Varying LOS between the lower and upper bounds of the 95% CI, the total cost was comparable between these regimens.Conclusions Overall, the cost for the management of acute agitation was similar between intramuscular ziprasidone and other antipsychotics. Compared with other antipsychotics, the higher medication cost of intramuscular ziprasidone can be offset by savings with shorter hospital stay. The results from this economic analysis were complementary to the findings in the published literature assessing the economic outcomes of oral ziprasidone.展开更多
Objective:To study the effect of ziprasidone combined with modified electroconvulsive therapy (MECT) on serum indexes and electrophysiological characteristics of schizophrenia. Methods: A total of 44 patients with sch...Objective:To study the effect of ziprasidone combined with modified electroconvulsive therapy (MECT) on serum indexes and electrophysiological characteristics of schizophrenia. Methods: A total of 44 patients with schizophrenia treated in our hospital between May 2014 and July 2016 were selected and randomly divided into MECT group and control group, MECT group received ziprasidone combined with MECT therapy and control group received ziprasidone therapy. Before treatment as well as 1 month, 2 months and 3 months after treatment, serum nerve cytokine levels and inflammatory factor levels as well as nerve electrophysiology parameters were detected.Results: 1 month, 2 months and 3 months after treatment, serum BDNF, GDNF and NGF levels of both groups were significantly higher than those before treatment, IL-1β, IL-6, IL-17 and TNF-α levels were significantly lower than those before treatment, P300 and N2-P3 latency were significantly shorter than those before treatment, and P300 and N2-P3 amplitude were significantly higher than those before treatment;serum BDNF, GDNF and NGF levels of MECT group were significantly higher than those of control group, IL-1β, IL-6, IL-17 and TNF-α levels were significantly lower than those of control group, P300 and N2-P3 latency were significantly shorter than those of control group, and P300 and N2-P3 amplitude were significantly higher than those of control group.Conclusion: Ziprasidone combined with modified electroconvulsive therapy can improve neuron function, reduce neuron damage and adjust nerve electrophysiology function.展开更多
Objective: To investigate the effect of ziprasidone on QTc in Chinese patients with schizophrenia. Methods: The study involved 27 patients with schizophrenia. Ziprasidone was initiated with 40 mg/day. From day 3 to da...Objective: To investigate the effect of ziprasidone on QTc in Chinese patients with schizophrenia. Methods: The study involved 27 patients with schizophrenia. Ziprasidone was initiated with 40 mg/day. From day 3 to day 7, the dose was increased gradually to 120-160 mg/d according to the effectiveness and tolerability. QTc values were measured at the beginning and month 6. Results: At the beginning of the 6 months treatment, the mean QTc interval of patients was(387.5±19.0) ms. At the end of the study, it was(402.9±23.6) ms. The difference has statistically significance(P<0.05). The mean QTc interval changed significantly throughout 6-months period but no one exceed the QTc dangerous limits. Significant correlation was found between QTc interval and the dose. Conclusion: In summary, our results suggest that ziprasidone has good tolerance in patient with schizophrenia despite its dose-related QTc prolongation. Ziprasidone have no pro-arrhythmic profile.展开更多
目的分析老年精神分裂症患者应用齐拉西酮与奥氮平治疗的效果及对患者糖脂代谢的影响。方法76例老年精神分裂症患者,采用随机数字表法分为观察组和对照组,各38例。观察组采用齐拉西酮治疗,对照组采用奥氮平治疗。对比两组患者临床疗效...目的分析老年精神分裂症患者应用齐拉西酮与奥氮平治疗的效果及对患者糖脂代谢的影响。方法76例老年精神分裂症患者,采用随机数字表法分为观察组和对照组,各38例。观察组采用齐拉西酮治疗,对照组采用奥氮平治疗。对比两组患者临床疗效、药物不良反应发生率、阳性与阴性症状量表(PANSS)评分、糖代谢指标[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、体质量指数(BMI)、脂代谢指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]。结果治疗后,两组阳性症状、阴性症状、精神病理评分及总分均低于治疗前,且观察组阳性症状评分(11.16±3.52)分、阴性症状评分(11.95±1.08)分、精神病理评分(23.62±3.15)分及总分(46.73±3.16)分均低于对照组的(16.95±4.09)、(16.35±3.16)、(28.69±4.07)、(61.99±4.07)分,差异有统计学意义(P<0.05)。观察组治疗总有效率97.37%与对照组的94.74%对比,差异无统计学意义(P>0.05)。对照组治疗后FBG、2 h PG、HbA1c、BMI均高于治疗前,差异有统计学意义(P<0.05);观察组治疗后FBG(5.12±0.65)mmol/L、2 h PG(7.28±1.05)mmol/L、HbA1c(5.05±1.36)%、BMI(23.65±2.17)kg/m^(2)均低于对照组的(6.08±0.70)mmol/L、(10.16±1.15)mmol/L、(7.11±1.39)%、(25.60±2.36)kg/m^(2),差异有统计学意义(P<0.05)。对照组治疗后TC、TG、LDL-C高于治疗前,HDL-C低于治疗前,差异有统计学意义(P<0.05);观察组治疗后TC(3.91±0.38)mmol/L、TG(0.88±0.35)mmol/L、LDL-C(3.10±0.75)mmol/L低于对照组的(4.70±0.55)、(1.16±0.50)、(3.95±0.80)mmol/L,HDL-C(1.16±0.30)mmol/L高于对照组的(1.01±0.20)mmol/L,差异有统计学意义(P<0.05)。观察组药物不良反应发生率15.79%低于对照组的36.84%,差异有统计学意义(P<0.05)。结论对老年精神分裂症患者采用齐拉西酮或奥氮平均可获得确切疗效,但齐拉西酮对患者糖脂代谢的影响较小,且药物安全性更高。展开更多
基金funded by Pfizer Investment.DL and LY are employees of Pfizer Investment and were involved in the design and write-up of the study
文摘Background Over 10 million Chinese are affected by schizophrenia. The annual cost of schizophrenia in China was estimated at US$2586 per patient.Aims The study has two aims:(1) to conduct a targeted literature review of the economic literature on oral ziprasidone in China, and(2) to develop an inpatient economic model that compared the cost of intramuscular ziprasidone with other regimens including electroconvulsive therapy(ECT) for the management of acute agitation in patients with schizophrenia from a hospital's perspective in China.Methods A targeted literature review was conducted using PubMed and the Chinese literature databases for studies published between January 2007 and December2017. Studies that assessed costs associated with oral ziprasidone treatment for schizophrenia in China were summarised. In the inpatient economic model,cost measures included hospital room and board,antipsychotics,ECT and medications for the management of extrapyramidal symptoms(EPS). Input for standard antipsychotic regimens and unit cost were obtained from the literature. Hospital length of stay(LOS), utilisation of ECT and incidence of EPS were derived from the literature and supplemented/validated with a survey of psychiatrists in China. Cost was presented in 2017 Chinese yuan.Results The average estimated LOS was 29 days with ziprasidone, 33 days with risperidone+benzodiazepine,32 days with olanzapine, 35 days with haloperidol and 29 days with ECT. The cost of antipsychotics was $1260 with ziprasidone, $137 with risperidone+benzodiazepine, $913 with olanzapine and $210 with haloperidol; ECT treatment costs $785. The base-case analysis suggested that higher antipsychotic cost with ziprasidone was offset by savings with shorter LOS. Using intramuscular ziprasidone for acute management was associated with a total cost of $11157, the lowest among all antipsychotic regimens($11 424 with risperidone+benzodiazepine, $11 711 with olanzapine and $11 912 with haloperidol) and slightly higher than ECT($10 606). The cost of antipsychotics and ECT accounted for 1 %-11 % of the total cost. Varying LOS between the lower and upper bounds of the 95% CI, the total cost was comparable between these regimens.Conclusions Overall, the cost for the management of acute agitation was similar between intramuscular ziprasidone and other antipsychotics. Compared with other antipsychotics, the higher medication cost of intramuscular ziprasidone can be offset by savings with shorter hospital stay. The results from this economic analysis were complementary to the findings in the published literature assessing the economic outcomes of oral ziprasidone.
文摘Objective:To study the effect of ziprasidone combined with modified electroconvulsive therapy (MECT) on serum indexes and electrophysiological characteristics of schizophrenia. Methods: A total of 44 patients with schizophrenia treated in our hospital between May 2014 and July 2016 were selected and randomly divided into MECT group and control group, MECT group received ziprasidone combined with MECT therapy and control group received ziprasidone therapy. Before treatment as well as 1 month, 2 months and 3 months after treatment, serum nerve cytokine levels and inflammatory factor levels as well as nerve electrophysiology parameters were detected.Results: 1 month, 2 months and 3 months after treatment, serum BDNF, GDNF and NGF levels of both groups were significantly higher than those before treatment, IL-1β, IL-6, IL-17 and TNF-α levels were significantly lower than those before treatment, P300 and N2-P3 latency were significantly shorter than those before treatment, and P300 and N2-P3 amplitude were significantly higher than those before treatment;serum BDNF, GDNF and NGF levels of MECT group were significantly higher than those of control group, IL-1β, IL-6, IL-17 and TNF-α levels were significantly lower than those of control group, P300 and N2-P3 latency were significantly shorter than those of control group, and P300 and N2-P3 amplitude were significantly higher than those of control group.Conclusion: Ziprasidone combined with modified electroconvulsive therapy can improve neuron function, reduce neuron damage and adjust nerve electrophysiology function.
基金Supported by the Natural Science Foundation of Shaanxi Province(2011JM4008)
文摘Objective: To investigate the effect of ziprasidone on QTc in Chinese patients with schizophrenia. Methods: The study involved 27 patients with schizophrenia. Ziprasidone was initiated with 40 mg/day. From day 3 to day 7, the dose was increased gradually to 120-160 mg/d according to the effectiveness and tolerability. QTc values were measured at the beginning and month 6. Results: At the beginning of the 6 months treatment, the mean QTc interval of patients was(387.5±19.0) ms. At the end of the study, it was(402.9±23.6) ms. The difference has statistically significance(P<0.05). The mean QTc interval changed significantly throughout 6-months period but no one exceed the QTc dangerous limits. Significant correlation was found between QTc interval and the dose. Conclusion: In summary, our results suggest that ziprasidone has good tolerance in patient with schizophrenia despite its dose-related QTc prolongation. Ziprasidone have no pro-arrhythmic profile.
文摘目的分析老年精神分裂症患者应用齐拉西酮与奥氮平治疗的效果及对患者糖脂代谢的影响。方法76例老年精神分裂症患者,采用随机数字表法分为观察组和对照组,各38例。观察组采用齐拉西酮治疗,对照组采用奥氮平治疗。对比两组患者临床疗效、药物不良反应发生率、阳性与阴性症状量表(PANSS)评分、糖代谢指标[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、体质量指数(BMI)、脂代谢指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]。结果治疗后,两组阳性症状、阴性症状、精神病理评分及总分均低于治疗前,且观察组阳性症状评分(11.16±3.52)分、阴性症状评分(11.95±1.08)分、精神病理评分(23.62±3.15)分及总分(46.73±3.16)分均低于对照组的(16.95±4.09)、(16.35±3.16)、(28.69±4.07)、(61.99±4.07)分,差异有统计学意义(P<0.05)。观察组治疗总有效率97.37%与对照组的94.74%对比,差异无统计学意义(P>0.05)。对照组治疗后FBG、2 h PG、HbA1c、BMI均高于治疗前,差异有统计学意义(P<0.05);观察组治疗后FBG(5.12±0.65)mmol/L、2 h PG(7.28±1.05)mmol/L、HbA1c(5.05±1.36)%、BMI(23.65±2.17)kg/m^(2)均低于对照组的(6.08±0.70)mmol/L、(10.16±1.15)mmol/L、(7.11±1.39)%、(25.60±2.36)kg/m^(2),差异有统计学意义(P<0.05)。对照组治疗后TC、TG、LDL-C高于治疗前,HDL-C低于治疗前,差异有统计学意义(P<0.05);观察组治疗后TC(3.91±0.38)mmol/L、TG(0.88±0.35)mmol/L、LDL-C(3.10±0.75)mmol/L低于对照组的(4.70±0.55)、(1.16±0.50)、(3.95±0.80)mmol/L,HDL-C(1.16±0.30)mmol/L高于对照组的(1.01±0.20)mmol/L,差异有统计学意义(P<0.05)。观察组药物不良反应发生率15.79%低于对照组的36.84%,差异有统计学意义(P<0.05)。结论对老年精神分裂症患者采用齐拉西酮或奥氮平均可获得确切疗效,但齐拉西酮对患者糖脂代谢的影响较小,且药物安全性更高。
