Müller Peter, Nerenz Hans, Schaefer Elke
Universitätsklinik für Psychiatrie und Psychotherapie, Göttingen, Germany.
Psychiatr Prax. 2002 Oct;29(7):388-91. doi: 10.1055/s-2002-34655.
Atypical neuroleptics have a lot of advantages compared with conventional substances. It is still disadvantageous that a depot-medication is missing. The role of the form of application has been studied in a schizophrenia-out-patient department. In 25 out-patients under therapy with atypical neuroleptics the time of rehospitalisation per year was retrospectively determined and compared with that of 25 out-patients receiving depot-medication. Both groups were comparable with regard to some patient-characteristics and predictors of the course of the disease. It turned out that for patients with depot-neuroleptics the time spent in hospital per year was half of that for patients under atypical drugs. It had been in the same range in both groups 4 to 6 years ago and had decreased until the last year of the catamnesis in patients with depot-medication, but not in those with atypics. Typical neuroleptics as oral medication are disadvantageous in this respect. Despite efforts to reach a good compliance in all patients, preferable effects of atypical drugs with regard to negative symptoms are opposed by less favourable rehospitalisation times. This has to be taken into consideration in differential indication.
与传统药物相比，非典型抗精神病药物有很多优点。然而，缺乏长效制剂仍然是其不足之处。在一个精神分裂症门诊对用药形式的作用进行了研究。回顾性确定了25名接受非典型抗精神病药物治疗的门诊患者每年的再次住院时间，并与25名接受长效制剂治疗的门诊患者进行比较。两组在一些患者特征和疾病进程预测因素方面具有可比性。结果发现，使用长效抗精神病药物的患者每年住院时间是非典型药物治疗患者的一半。4至6年前两组情况相同，在随访的最后一年，长效制剂治疗患者的住院时间有所下降，而非典型药物治疗患者则没有。在这方面，作为口服药物的典型抗精神病药物存在劣势。尽管努力使所有患者都有良好的依从性，但非典型药物在阴性症状方面的较好疗效却被不太有利的再次住院时间所抵消。在鉴别诊断时必须考虑到这一点。
