Kern R S, Green M F, Marshall B D, Wirshing W C, Wirshing D, McGurk S R, Marder S R, Mintz J
Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, USA.
Schizophr Bull. 1999;25(2):223-32. doi: 10.1093/oxfordjournals.schbul.a033375.
The introduction of the new generation of antipsychotic medications for the treatment of schizophrenia has been accompanied by a growing interest in the neurocognitive effects of these drugs. The present study compared the effects of risperidone and haloperidol on secondary memory in a group of treatment-resistant schizophrenia patients. The study design included a baseline phase and two double-blind phases in which patients were randomly assigned to medication under two different dose conditions (fixed dose and flexible dose). Secondary memory was assessed at baseline, fixed-dose, and flexible-dose phases, using the California Verbal Learning Test (CVLT). Six measures were selected, which formed three factors (general verbal learning ability, retention, and learning strategy). Risperidone-treated patients showed greater improvement than haloperidol-treated patients in general verbal learning ability, a finding characterized by significant treatment effects on CVLT measures of learning acquisition, recall consistency, and recognition memory. After controlling for benztropine status, differences on the measures of learning acquisition and recall consistency remained significant, and differences in recognition memory weakened slightly (p = 0.07). No significant treatment effects were noted on retention or learning strategy. These findings suggest that risperidone may exert a facilitating effect on the acquisition of new verbal information, an effect that does not appear to be due to the activation of semantic encoding strategies.
新一代抗精神病药物用于治疗精神分裂症的同时，人们对这些药物的神经认知效应的兴趣也与日俱增。本研究比较了利培酮和氟哌啶醇对一组难治性精神分裂症患者情景记忆的影响。研究设计包括一个基线期和两个双盲期，在此期间患者被随机分配接受两种不同剂量条件（固定剂量和灵活剂量）的药物治疗。使用加利福尼亚言语学习测验（CVLT）在基线期、固定剂量期和灵活剂量期评估情景记忆。选取了六项指标，这些指标形成了三个因素（一般言语学习能力、记忆保持和学习策略）。在一般言语学习能力方面，接受利培酮治疗的患者比接受氟哌啶醇治疗的患者有更大改善，这一发现表现为对CVLT学习获得、回忆一致性和识别记忆指标有显著治疗效果。在控制苯海索状态后，学习获得和回忆一致性指标上的差异仍然显著，识别记忆方面的差异略有减弱（p = 0.07）。在记忆保持或学习策略方面未观察到显著治疗效果。这些发现表明，利培酮可能对新言语信息的获得产生促进作用，这种作用似乎并非源于语义编码策略的激活。
