Rollnik Jens D, Borsutzky Marthias, Huber Thomas J, Mogk Hannu, Seifert Jürgen, Emrich Hinderk M, Schneider Udo
Department of Neurology and Clinical Neurophysiology, Medical School of Hannover, Hannover, Germany.
Neuropsychobiology. 2002;45(2):74-80. doi: 10.1159/000048680.
Atypical neuroleptics seem to be more beneficial than typical ones with respect to long-term neuropsychological functioning. Thus, most studies focus on the long-term effects of neuroleptics. We were interested in whether atypical neuroleptic treatment is also superior to typical drugs over relatively short periods of time.
We studied 20 schizophrenic patients [10 males, mean age 35.5 years, mean Brief Psychiatric Rating Scale (BPRS) score at entry 58.9] admitted to our hospital with acute psychotic exacerbation. Nine of them were treated with typical and 11 with atypical neuroleptics. In addition, 14 healthy drug-free subjects (6 males, mean age 31.2 years) were enrolled in the study and compared to the patients. As neuropsychological tools, a divided attention test, the Vienna reaction time test, the Benton visual retention test, digit span and a Multiple Choice Word Fluency Test (MWT-B) were used during the first week after admission, within the third week and before discharge (approximately 3 months).
Patients scored significantly worse than healthy controls on nearly all tests (except Vienna reaction time). Clinical ratings [BPRS and Positive and Negative Symptom Scale for Schizophrenia (PANSS)] improved markedly (p < 0.01), without a significant difference between typical and atypical medication. Clinical improvement (PANSS total score) correlated with less mistakes on the Benton test (r = 0.762, p = 0.017) and an improvement on the divided attention task (r = 0.705, p = 0.034). Neuropsychological functioning (explicit memory, p < 0.01; divided attention, p < 0.05) moderately improved for both groups under treatment but without a significant difference between atypical and typical antipsychotic drugs.
Over short periods of time (3 months), neuropsychological disturbances in schizophrenia seem to be moderately responsive to both typical and atypical neuroleptics.
非典型抗精神病药物在长期神经心理功能方面似乎比典型抗精神病药物更有益。因此，大多数研究关注抗精神病药物的长期影响。我们感兴趣的是，在相对较短的时间内，非典型抗精神病药物治疗是否也优于典型药物。
我们研究了20例因急性精神病性加重而入院的精神分裂症患者[10名男性，平均年龄35.5岁，入院时简明精神病评定量表（BPRS）平均得分58.9]。其中9例接受典型抗精神病药物治疗，11例接受非典型抗精神病药物治疗。此外，14名无药物使用史的健康受试者（6名男性，平均年龄31.2岁）参与研究并与患者进行比较。作为神经心理学工具，在入院后第一周、第三周和出院前（约3个月）使用了一项分心测试、维也纳反应时间测试、本顿视觉保持测试、数字广度测试和多项选择词语流畅性测试（MWT-B）。
几乎所有测试中，患者的得分均显著低于健康对照组（维也纳反应时间测试除外）。临床评分[BPRS和精神分裂症阳性和阴性症状量表（PANSS）]显著改善（p < 0.01），典型药物和非典型药物之间无显著差异。临床改善（PANSS总分）与本顿测试中较少的错误（r = 0.762，p = 0.017）以及分心任务的改善（r = 0.705，p = 0.034）相关。两组治疗期间神经心理功能（外显记忆，p < 0.01；分心，p < 0.05）均有中度改善，但非典型和典型抗精神病药物之间无显著差异。
在短时间内（3个月），精神分裂症的神经心理障碍似乎对典型和非典型抗精神病药物均有中度反应。
