Keefe Richard S E, Seidman Larry J, Christensen Bruce K, Hamer Robert M, Sharma Tonmoy, Sitskoorn Margriet M, Rock Stephanie L, Woolson Sandra, Tohen Mauricio, Tollefson Gary D, Sanger Todd M, Lieberman Jeffrey A
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
Biol Psychiatry. 2006 Jan 15;59(2):97-105. doi: 10.1016/j.biopsych.2005.06.022. Epub 2005 Sep 2.
Neurocognitive deficits are severe in first-episode psychosis.
Patients (N = 263) with first-episode psychosis (schizophrenia, schizoaffective, or schizophreniform disorders) were randomly assigned to double-blind treatment with olanzapine (mean 11.30 mg/day) or haloperidol (mean 4.87 mg/day) for 104 weeks. A neurocognitive battery was administered at baseline (n = 246) and 12 (n = 167), 24 (n = 126), 52 (n = 89), and 104 (n = 46) weeks during treatment. Weighted principal component and unweighted composite scores were derived from individual tests.
Both treatment groups demonstrated significant improvement on both composite scores. On the basis of the weighted composite score, olanzapine had greater improvement than haloperidol only at 12 (p = .014) and 24 (p = .029) weeks. For the unweighted composite, olanzapine had significantly better improvement compared with haloperidol only at week 12 (p = .044). At week 12 only, olanzapine improved performance on the Digit Symbol and Continuous Performance Test significantly more than haloperidol.
Both antipsychotic agents appeared to improve neurocognitive functioning among first-episode psychosis patients with schizophrenia. A significantly greater benefit in terms of neurocognitive improvement was found with olanzapine than with haloperidol at weeks 12 and 24.
首发精神病患者存在严重的神经认知缺陷。
将263例首发精神病（精神分裂症、分裂情感性障碍或精神分裂症样障碍）患者随机分配至接受奥氮平（平均11.30毫克/天）或氟哌啶醇（平均4.87毫克/天）双盲治疗104周。在治疗基线期（n = 246）以及治疗的第12周（n = 167）、24周（n = 126）、52周（n = 89）和104周（n = 46）时进行神经认知成套测验。加权主成分得分和未加权综合得分由各个测试得出。
两个治疗组在综合得分上均有显著改善。基于加权综合得分，仅在第12周（p = 0.014）和第24周（p = 0.029）时，奥氮平的改善程度大于氟哌啶醇。对于未加权综合得分，仅在第12周时奥氮平的改善显著优于氟哌啶醇（p = 0.044）。仅在第12周时，奥氮平在数字符号测验和连续操作测验中的表现改善显著多于氟哌啶醇。
两种抗精神病药物似乎均可改善精神分裂症首发精神病患者的神经认知功能。在第12周和第24周时，发现奥氮平在神经认知改善方面比氟哌啶醇有显著更大的益处。
