Barkić Jelena, Filaković Pavo, Radanović-Grgurić Ljiljana, Koić Oliver, Laufer Davor, Pozgain Ivan, Koić Elvira, Hotujac Ljubomir
Department of Psychiatry, University Hospital Osijek, Osijek, Croatia.
Coll Antropol. 2003;27 Suppl 1:111-8.
Introduction of the antipsychotics of the second generation (SGA) into the therapy of schizophrenia roused expectations that, finally, the cognitive dysfunction in schizophrenia could be eliminated by psychopharmacological therapy. The purpose of the study was to verify the effect of atypical antipsychotic risperidone on cognitive functions in schizophrenic patients. The study was carried out upon 48 male schizophrenic patients aged 21-47 years who were switched from the antipsychotics of the first generation (FGA) to the antipsychotic risperidone, due to intolerance, during the treatment. Intelligence, abstract and concrete thinking and mental speed, attention, and short-term non-verbal memory prior to the switch, one month after the switch, and three months after the switch to risperidone, were evaluated. One month after the switch the number of subjects with severe impairment of intellectual abilities decreased significantly from 62% to 15% and after three months the number was even lower-8%. The impairment of concrete and abstract thinking and mental speed also showed the same tendencies of decrease. The improvement of the cognitive functioning after the switch from the antipsychotics of the first generation to the antipsychotic risperidone is explained by removal of the antipsychotics of the first generation from the therapy and the consequential disinhibition of secondary cognitive impairments and by decreased average dose of anticholinergic and decreased number of patients who need anticholinergic therapy beside risperidone. The possibility of clear pro-cognitive effect of risperidone is suggested and its verification is proposed with strict control of other factors that improve cognitive functioning of schizophrenic patients during the treatment.
第二代抗精神病药物（SGA）被引入精神分裂症治疗领域，引发了人们的期待，即最终精神分裂症的认知功能障碍能够通过心理药物治疗得以消除。本研究的目的是验证非典型抗精神病药物利培酮对精神分裂症患者认知功能的影响。该研究针对48名年龄在21至47岁之间的男性精神分裂症患者开展，这些患者在治疗期间因不耐受而从第一代抗精神病药物（FGA）换用抗精神病药物利培酮。在换用药物前、换用后1个月以及换用利培酮后3个月，对患者的智力、抽象和具体思维、思维速度、注意力以及短期非言语记忆进行了评估。换用药物1个月后，智力严重受损的受试者数量从62%显著降至15%，3个月后这一数字更低，为8%。具体和抽象思维以及思维速度的受损情况也呈现出相同的下降趋势。从第一代抗精神病药物换用抗精神病药物利培酮后认知功能的改善，是由于第一代抗精神病药物从治疗中停用，从而解除了继发性认知障碍的抑制作用，以及抗胆碱能药物平均剂量降低，且除利培酮外需要抗胆碱能治疗的患者数量减少。研究表明利培酮可能具有明显的促认知作用，并建议在严格控制治疗期间改善精神分裂症患者认知功能的其他因素的情况下对其进行验证。
