回复1023楼 徐艾
回复1023楼 徐艾:回复1020楼 章华
雷沙吉兰(或译雷沙吉林)是早期帕金森病的首选药物。
国外学者最近对唑尼沙胺治疗早期帕金森病进行过临床研究(详见英文版)。十位明确诊断早期帕金森病(没有进行过任何药物治疗)的患者,参与了三个月的唑尼沙胺单药治疗,所有患者第一个月服用每天25mg,第二及第三个月增加到每天50mg,临床报告显示,服用第一个月,帕金森病统一评分量表没有明显差异,而第二及第三个月,帕金森病统一评分量表及震颤相关项目得到明显改善,其中三位患者的快动眼睡眠行为障碍也得到改善,睡眠质量转佳。
结论是唑尼沙胺单药治疗早期帕金森病是可行的(尤其是震颤型),可以改善运动状况和快动眼睡眠行为障碍。
以上数据和我们得到的资料是一致的,二年前我已经主张唑尼沙胺可以用于早期帕金森病的治疗,早期帕金森病运动症状及快动眼睡眠行为障碍的改善病例也有很多。
唑尼沙胺和雷沙吉兰共用没有问题。
Preliminary study of zonisamide monotherapy in de novo patients with early Parkinson’s disease
Ken Ikeda*, Sayori Hanashiro, Masahiro Sawada andYasuo Iwasaki
Article first published online: 6 MAR 2015
DOI: 10.1111/ncn3.179
© 2015 Japanese Society of Neurology and Wiley Publishing Asia Pty Ltd
Issue
Background
Little is known about single administration of zonisamide in Parkinson’s disease patients.
Aim
We aimed to evaluate the therapeutic effects of zonisamide monotherapy in early Parkinson’s disease patients.
Methods
A total of 10 untreated (de novo) patients with Yahr stage I or II participated. Zonisamide was given at a daily dose of 25 mg for 1 month and increased to 50 mg for the next 2 months. Unified Parkinson’s Disease Rating Scale parts I–IV and tremor-related Unified Parkinson’s Disease Rating Scale (items 16, 20 and 21) were examined every month. Serum zonisamide concentrations and urinary homovanillic acid concentrations were measured. Three patients had rapid eye movement sleep behavior disorder.
Results
At 1 month after zonisamide treatment, Unified Parkinson’s Disease Rating Scale scores did not differ from the baseline scores statistically. At 2 and 3 months after zonisamide treatment, Unified Parkinson’s Disease Rating Scale part III and tremor-related scores were reduced significantly compared with pretreatment (P < 0.01). Sleep state improved markedly in three patients with rapid eye movement sleep behavior disorder at 1–2 months after zonisamide treatment. The mean serum concentrations of zonisamide (standard deviation) were 2.0 μg/mL (0.9) at 25 mg/day and 6.6 μg/mL (2.3) at 50 mg/day. Urinary homovanillic acid concentrations were not altered before and after zonisamide administration.
Conclusions
The present study showed that zonisamide monotherapy improved motor and sleep dysfunction in de novo patients with early Parkinson’s disease. Significant therapeutic benefits were present within 1–2 months. Finally, the data highlight a therapeutic potential of zonisamide monotherapy in tremor-predominant patients with early Parkinson’s disease.