Meltzer H Y
Department of Psychopharmacology, Vanderbilt University School of Medicine, Nashville, Tenn 37212, USA.
J Clin Psychiatry. 1999;60 Suppl 3:3-7; discussion 8.
Although some patients with schizophrenia may have a single episode and recover, the vast majority remain ill and unable to work for life. In the United States, patients with schizophrenia use 2.5% of the annual total health care allocations. The atypical antipsychotics, particularly when combined with psychosocial treatment, hold the promise of improving outcome and reducing the economic burden on society. Both clinical outcome and cost effectiveness are best evaluated in the context of a comprehensive assessment of a range of meaningful outcome measures studied in clinical situations. Evidence exists that the atypical antipsychotics not only reduce positive and negative symptoms and cause fewer side effects than conventional neuroleptics, but also lessen cognitive impairment, lead to a better quality of life, and have antidepressant effects, all of which should result in improved outcome in patients with schizophrenia. Increasing the availability of the atypical agents should be cost effective for society by restoring productivity in some patients with schizophrenia.
尽管一些精神分裂症患者可能仅发作一次便康复，但绝大多数患者会终生患病且无法工作。在美国，精神分裂症患者占用了年度医疗保健总拨款的2.5%。非典型抗精神病药物，尤其是与心理社会治疗相结合时，有望改善治疗效果并减轻社会经济负担。临床疗效和成本效益最好在对临床研究中一系列有意义的疗效指标进行全面评估的背景下进行评估。有证据表明，非典型抗精神病药物不仅能减轻阳性和阴性症状，且比传统抗精神病药物副作用更少，还能减轻认知障碍，提高生活质量，并具有抗抑郁作用，所有这些都应能改善精神分裂症患者的治疗效果。增加非典型药物的可及性，对于社会而言，通过恢复部分精神分裂症患者的生产力，应具有成本效益。
