만성 여성 정신분열병 환자에서 Estrogen 병합투여의 임상시도

A Clinical Trial of Combined Treatment with Estrogen and Antipsychotics in Females with Chronic Schizophrenia

본 연구는 만성 정신분열병 여성환자에서 항정신병약물에 대한 estrogen병합투여 효과를 정신병리 측면에서 조사한 것이다. Estrogen 투약군과 대조군으로 나누어 8주에 걸쳐 시행하였고, 그 결과를 PANSS, CGI를 통하여 비교하였다. 8주간의 연구기간 동안 PANSS, CGI모두에서 투약군이 대조군보다 유의한 호전을 보였다. 투약군에서 연구 8주동안의 PANSS 각 소항목군의 변화율은 양성증상 30.52%, 음성증상 15.06%, 일반정신병리증상 13.60%로 양성증상이 다른 군에 비하여 큰 호전을 보였다. 이상의 연구결과는 만성정신분열병의 치료에 있어 기존의 항정신병 약물과 estrogen의 병합투여가 치료적 효과적가 있다는 것을 제시하였다. 또한 estrogen의 항정신병적 효과의 기전은 명확치 않지만, estrogen이 뇌에서 도파민과 세로토닌체계에 영향을 주어 정신분열병의 호전에 기여했을 것으로 추측된다.

Objective : This study was a open clinical trial aimed at exploring the effectiveness of combined treatment with estrogen and antipsychotics to the chronic female schizophrenics. Method : 40 female patients who met DSM-VI criteria for schizophrenia who were chronically ill were randomly assigned to estrogen group(EG) and control group(CG). EG patients were received estrogen 1.25mg for 8weeks in addition to their routine antipsychotic regimens. CG patients were received their routine antipsychotic regimens only. Both groups were evaluated by PANSS(Postive and Negative Syndrome Scale), CGI(Clinical Global Impression) at 0, 4, 8 week during the trial period and compaired with each other. Results : 40 female patients have completed the study during 8weeks. EG was significantly improved in PANSS and CGI scores than CG during the 8weeks. In EG patients, all symptom subtypes(positive symptoms, negative symptoms, general psychopathology symptoms) of PANSS were significantly improved and positive symptoms were most significantly improved at 8week. Conclusions : This results support the clinical value of combined estrogen therapy among chronic female schizophrenics.