Gasquet Isabelle, Haro Josep Maria, Novick Diego, Edgell Eric T, Kennedy Liam, Lepine Jean Pierre
INSERM U669, Maison des Adolescents, Hôpital Cochin, AP-HP, Paris, France.
Int Clin Psychopharmacol. 2005 Jul;20(4):199-205. doi: 10.1097/00004850-200507000-00002.
The present study aimed to compare health outcomes and tolerability according to antipsychotic medication (olanzapine, risperidone or an oral typical antipsychotic) after 6 months of treatment in a group of 919 schizophrenic patients who had never previously been treated with antipsychotics. Demographic and clinical predictors of outcome were also identified. Data were extracted from the Schizophrenia Outpatient Health Outcomes (SOHO) study, a prospective, observational study of schizophrenia treatment in 10 European countries. Patients who initiated olanzapine were more likely to have a clinical response than those in the risperidone cohort, and had a greater improvement in quality of life than patients in the risperidone or typical antipsychotic cohorts. High negative and depression symptom scores at baseline and the presence of extrapyramidal symptoms at baseline predicted a worse clinical response, whereas hostile behaviour, paid employment and substance abuse predicted a better clinical outcome. The olanzapine cohort gained more weight than patients in the risperidone cohort, but no significant difference in weight gain was observed between olanzapine and the oral typical antipsychotic cohort. The results should be interpreted conservatively due to the observational study design.
本研究旨在比较919名既往从未接受过抗精神病药物治疗的精神分裂症患者在接受6个月抗精神病药物(奥氮平、利培酮或口服传统抗精神病药物)治疗后的健康结局和耐受性。同时还确定了结局的人口统计学和临床预测因素。数据取自精神分裂症门诊健康结局(SOHO)研究,这是一项在10个欧洲国家进行的关于精神分裂症治疗的前瞻性观察性研究。与利培酮队列中的患者相比,开始使用奥氮平的患者更有可能出现临床反应,并且与利培酮或传统抗精神病药物队列中的患者相比,生活质量改善更大。基线时高阴性和抑郁症状评分以及基线时存在锥体外系症状预示着临床反应较差,而敌对行为、有偿就业和药物滥用则预示着更好的临床结局。奥氮平队列的体重增加比利培酮队列的患者更多,但奥氮平与口服传统抗精神病药物队列之间在体重增加方面未观察到显著差异。由于本研究为观察性研究设计,因此对结果的解释应谨慎。