Voruganti L, Cortese L, Oyewumi L, Cernovsky Z, Zirul S, Awad A
Department of Psychiatry, University of Western Ontario, Ontario, London, Canada.
Schizophr Res. 2000 Jun 16;43(2-3):135-45. doi: 10.1016/s0920-9964(99)00154-1.
This study compared the effectiveness of conventional and novel antipsychotic drugs from a patient's perspective. Five comparable groups of schizophrenic patients (n=230) clinically stabilized on conventional antipsychotic drugs, risperidone, olanzepine, quetiapine or clozapine for a period of 6months or longer were cross-sectionally evaluated. Patients' clinical symptom profile, subjective responses and attitudes toward drugs, prevalence of dysphoria, akathisia, abnormal involuntary movements and Parkinsonian symptoms, and quality of life were ascertained using standardized rating scales. Between-group differences were examined with analysis of variance and chi-square tests. Patients receiving novel antipsychotic drugs experienced fewer side-effects, reported positive subjective responses and favourable attitudes toward their treatment, and revealed a lower prevalence of neuroleptic dysphoria. The differences were statistically significant (p<0.05) with the risperidone, olanzepine and quetiapine groups. Self-rated quality of life, measured with the sickness impact profile, was also significantly better among patients receiving novel antipsychotic drugs. These perceived benefits, however, were not reflected in the clinician rated (objective) measures of psychosocial functioning and quality of life. These findings substantiate the general notion that novel antipsychotic medications are uniformly better tolerated as indicated by the measures of subjective responses, side-effects and self rated quality of life.
本研究从患者角度比较了传统抗精神病药物和新型抗精神病药物的疗效。对五组（n = 230）临床症状稳定且已使用传统抗精神病药物、利培酮、奥氮平、喹硫平或氯氮平治疗6个月及以上的精神分裂症患者进行了横断面评估。使用标准化评定量表确定患者的临床症状特征、对药物的主观反应和态度、烦躁不安、静坐不能、异常不自主运动和帕金森症状的发生率以及生活质量。采用方差分析和卡方检验来检验组间差异。接受新型抗精神病药物治疗的患者副作用较少，报告了积极的主观反应和对治疗的良好态度，且显示出精神抑制性烦躁不安的发生率较低。利培酮、奥氮平和喹硫平组的差异具有统计学意义（p<0.05）。使用疾病影响量表测量的自评生活质量在接受新型抗精神病药物治疗的患者中也显著更好。然而，这些感知到的益处并未体现在临床医生评定的（客观）社会心理功能和生活质量指标中。这些发现证实了这样一个普遍观点，即从主观反应、副作用和自评生活质量指标来看，新型抗精神病药物的耐受性总体上更好。
