Study Of Olanzapine In The Treatment Of Organic Mental Disorders

Clinical data:This research selection in March, 2008 to October, 2009 period seeing a doctor the patient who applies the Austria nitrogen even treatment in the Changchun area's brain organic dysphrenia, enters the group standard to conform to ICD-10 already "Illness To get sick And Related Healthy Question International Classification" the 10th edition of brain organic illness sickness result dysphrenia diagnosis, the concise neurosis evaluation meter (BPRS) total score≥18 point, has not used any neurosis medicine, eliminates the critically ill neurosis and the active material and the body illness sickness result dysphrenia abreast in row. Altogether 171 examples, 104 examples to apply the Austria nitrogen even treatment, 67 examples to apply the fluorine pai ding mellow treatment.Research methods:Diagnosis and classification:According to ICD-10 already "Disease And Related Healthy Question's International Classification" the 10th edition, according to the symptom standard, the course standard, the order of severity standard, the elimination standard determined. This article classifies the brain organic neurosis for the brain flesh wound, the apoplexy and old stage dysphrenia[34].Treatments: Olanzapine (each piece of 10mg) takes orally, the dosage is 2.5~5mg/d generally, 2.5mg/d, adds for the first time according to the patient situation 1 week to 5~10mg/d. Fluorine pai ding mellow group: The fluorine pai ding mellow piece (each piece of 2mg) takes orally, the dose range is 2~12mg/d, divides 2 times to take, 2mg/d, adds for the first time according to the patient situation 1 week to 5~12mg/d. The patient who cannot take orally the medicine regarding some gives the fluorine pai ding mellow inoculation fluid dosage to equate in the oral administration dosage. If condition need, but in the short-term uses Pu nai Luo river, An Tanhe medicines and so on calm hypnosis, simultaneously records the use dosage, the time and the curative effect.Evaluation tool:Uses concise neurosis symptom evaluation meter (BPRS), and untoward effect meter (TESS). Before the evaluation method is the treatment, evaluates BPRS 1 time, treats the latter 2, 4, 6, 8 weeks to evaluate BPRS, TESS each 1 time separately. All evaluations complete by way of clinician. Concise neurosis meter (BPRS) altogether evaluates 5 times. Reduces the fraction by the BPRS total score to take the curative effect deliberated index.Statistical analysis:The brain organic dysphrenia type which causes to the different reason using the Austria nitrogen even treatment use dosage, the effect time, disease extension turns over to and the clinical side reaction carries on the description, and inputs the SSPS13.0 software, after before the treatment, the treatment, uses the differential value T-test to carry on the analysis, the group effectiveness comparison uses the chi-square test.comparison between efficient using x2 inspection, P < 0.05 when significant difference.Effectiveness:We can see that application of olanzapine BPRS total score after treatment 1 week after treatment began to decline, compared with before treatment was significant (P <0.05), 2,4,8 week after treatment compared with before treatmentsignificant (P <0.01).Accordingly, the clinical treatment of olanzapine can be considered mental disorders due to brain organic diseases, which began 1 week after treatment onset, 2 weeks can be achieved very significant results. BPRS total score after the application of haloperidol in the treatment 2 weeks after treatment began to decline. After 4-8 weeks of continuous treatment can achieve very significant results. And between the end of 8 weeks of treatment there was no significant difference in efficacy. We can see that the brain of olanzapine in the treatment of organic mental disorders when the overall efficacy and haloperidol equivalent, but in terms of improving the onset of psychiatric symptoms significantly earlier than haloperidol.Application of 104 cases of patients treated with olanzapine in 81 patients clinically cured, 11 cases significantly improved, improved in 7 cases, 5 cases ineffective. Cure rate of 77.8%, 4.8% inefficiency.Three groups between patients with cerebral organic mental disorders were compared between groups by x2, P = 0.352> 0.05.Application of the groups that olanzapine therapy there was no significant difference.We will treat each item began each interview after the TESS score minus baseline score draw score sum. Without the meter is divided into 0.Take one of the highest entry score analysis, the case of a total of 1 to cases of adverse reactions [36].Of Table Mingao mirtazapine group rate of adverse drug reactions occur less extrapyramidal side effects of haloperidol group were significantly higher than the olanzapine group, especially in muscle rigidity, tremor, akathisia, the other adverse reactionsThe incidence is roughly equal.In addition, olanzapine treatment in 104 patients, 8 weeks after treatment, 8 cases (7.69%, 8 / 104) in patients with mild hyperglycemia, 5 patients (4.8%, 5 / 104) occurred Lightdegree of cholesterol. None of the patients blood, urine and ECG abnormalities. Adverse reactions:Common side effects of olanzapine include: dizziness, appetite increase, peripheral edema, orthostatic hypotension, acute or delayed movement disorders including Parkinson's disease extrapyramidal-like symptoms, akathisia, dystonia, transient resistancecholinergic effects include dry mouth and constipation, in addition to liver alanine aminotransferase and aspartate aminotransferase symptoms of a transient increase, especially in the early treatment.Plasma prolactin concentration increased slightly occasional transient.Comparison of the Li and other treatment of olanzapine and haloperidol in acute schizophrenia, the efficacy and safety, found that olanzapine group fewer adverse drug reactions, side effects were significantly lower than the haloperidol group[44]. Zhang Man have compared olanzapine and haloperidol in the treatment of mental disorders associated with cerebrovascular disease the efficacy and safety, found that olanzapine group fewer adverse reactions, mainly dizziness and drowsiness; the haloperidol group moreincluding extrapyramidal reactions, tachycardia, dizziness, salivation[45]. Our results show that olanzapine group fewer adverse drug reactions, extrapyramidal side effects of haloperidol group were significantly higher than the olanzapine group, especially in muscle rigidity, tremor, akathisia and so on.Cholinergic side effects and no significant difference between the two groups.It should be noted that the process of olanzapine in the treatment of elevated blood glucose and lipids in the side effects, it is proposed to accept patients treated with olanzapine should be regular monitoring of blood lipids, blood glucose, especially for those with a family history of diabetes, history of hypertension,patients with obesity to be cautious.In short, we apply the olanzapine treatment of cerebral organic mental disorder, the results show: BPRS factor scores decreased from the beginning of the weekend, rapid onset than haloperidol, the overall efficacy and haloperidol in the very same time, adverse reactionsthan haloperidol, the patient was well tolerated and safe dose of 2.5 to 20 mg, a wide range of general hospital for outpatient and ward medicine, physicians easy to grasp for integrated medicine, it is worth to further promote the use of clinical.Conclusion:This study shows that:1. olanzapine can effectively control the various causes of brain organic mental disorder the patient's behavior, irritability, delirium, and various psychotic symptoms.2. onset time was earlier than haloperidol, and haloperidol and the overall effect quite.3. treatment of a variety of causes of cerebral organic mental disorder, and no significant difference in efficacy.4. caused by antipsychotic olanzapine common extrapyramidal system was significantly lower than that of haloperidol.