Отправлено 02 Июль 2010 - 03:41
Более высокая доза рисполепта может вызвать экстрапирамидные расстройства. Глицин можно смело убрать. Я все-таки склоняюсь к мнению о добавлении миртазапина (15мг), т.к. как я понял доза рисполепта в 4 мг купирует психотическую симптоматику и остается лишь нарушение сна. Миртазапин (ремерон, миртазонал) отпускается в аптеках также как и другие психотропные средства, включая рисполепт. В любом случае изменения терапии необходимо проконсультироваться с лечащим врачом.
Информация про сочетание миртазапина и рисперидона:
Schizophr Res. 2010 Feb;116(2-3):101-6. Epub 2009 Dec 2.
The effect of mirtazapine add on therapy to risperidone in the treatment of schizophrenia: a double-blind randomized placebo-controlled trial.
Abbasi SH, Behpournia H, Ghoreshi A, Salehi B, Raznahan M, Rezazadeh SA, Rezaei F, Akhondzadeh S.
Research Unit, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Abstract
It has been reported that mirtazapine would be helpful for treating negative symptoms in schizophrenia. Nevertheless, the results are contradictory so far. This study was designed to investigate the effect of mirtazapine added to risperidone as augmentation therapy in patients with chronic schizophrenia and prominent negative symptoms in a double-blind and randomized clinical trial. Eligible participants in the study were 40 patients with chronic schizophrenia with ages ranging from 19 to 49 years. All patients were inpatients and were in the active phase of the illness, and met DSM-IV-TR criteria for schizophrenia. Patients were allocated in a random fashion 20 to risperidone 6 mg/day plus mirtazapine 30 mg/day and 20 to risperidone 6 mg/day plus placebo. The principal measure of the outcome was Positive and Negative Syndrome Scale (PANSS). The mirtazapine group had significantly greater improvement in the negative symptoms and PANSS total scores over the eight-week trial. Therapy with 30 mg/day of mirtazapine was well tolerated and no clinically important side effects were observed. The present study indicates mirtazapine as a potential combination treatment strategy for chronic schizophrenia particularly for negative symptoms. 2009 Elsevier B.V. All rights reserved.
PMID: 19959338 [PubMed - indexed for MEDLINE]
Eur. Psychopharm. Volume 10, Issue 1, Pages 51-57 (December 1999)
Lack of drug interactions between mirtazapine and risperidone in psychiatric patients: a pilot study
A.J.M. Loonenab, C.H. Doorschotb, M.C.J.M. Oostelbosb, J.M.A. SitsencCorresponding Author Informationemail address
Received 9 June 1999; accepted 7 September 1999.
Abstract
An open-label, non-randomized, pilot study has been performed in inpatients in need of treatment with an antipsychotic (risperidone) and an antidepressant (mirtazapine) with the objective to preliminarily assess a possible pharmacokinetic interaction and the tolerability of this combination. A 1–4-week single drug treatment phase (risperidone 1–3 mg bid or mirtazapine 30 mg nocte) was followed by a 2–4-week combined drug treatment phase at unchanged doses. Twelve patients were enrolled, nine of whom were treated with risperidone in the single drug phase. Results of plasma level measurements are available for six patients and indicate that adding mirtazapine to risperidone does not alter steady-state plasma concentrations of risperidone and its 9-hydroxy metabolite. Data from one patient suggest that adding risperidone to mirtazapine does not result in clinically relevant changes in plasma concentrations of either compound. The combination was well tolerated and no major or relevant adverse events were observed. Adding risperidone to mirtazapine probably does not necessitate a change of the dosage of either drug, but more extensive investigations are needed.