Neylan T C, van Kammen D P, Kelley M E, Peters J L
Highland Drive Veterans Affairs Medical Center, Pittsburgh, Pa. 15206.
Arch Gen Psychiatry. 1992 Aug;49(8):643-9. doi: 10.1001/archpsyc.1992.01820080051008.
We examined the state-dependent contribution of neuroleptic withdrawal and psychotic relapse in influencing sleep measures. Eighteen clinically stable male schizophrenic patients taking haloperidol were studied with 3 nights of polysomnography for baseline measures and again after neuroleptic withdrawal. Sleep measures were also obtained at the point of relapse (n = 9) or after a 6-week drug-free period if the patient remained clinically stable (n = 9). Neuroleptic withdrawal led to a global deterioration of rapid eye movement and non-rapid eye movement sleep and a reduction of rapid eye movement latency in both groups. Relapsers differed from nonrelapsers in that they had a larger decrease in total sleep time, sleep efficiency, total non-rapid eye movement sleep, and stage 2 sleep. The level of psychosis was inversely correlated with sleep efficiency, total sleep time, and stage 4 sleep in the drug-free patients. Our data suggest that clinical state needs to be identified in sleep studies of drug-free patients.
我们研究了抗精神病药物撤药和精神病复发对睡眠指标的状态依赖性影响。对18名服用氟哌啶醇且临床稳定的男性精神分裂症患者进行了研究，通过3晚的多导睡眠图记录来获取基线指标，在抗精神病药物撤药后再次进行记录。在复发时（n = 9）或如果患者临床仍保持稳定，则在6周无药期后（n = 9）也获取睡眠指标。抗精神病药物撤药导致两组患者的快速眼动睡眠和非快速眼动睡眠整体恶化，快速眼动潜伏期缩短。复发患者与未复发患者的不同之处在于，他们的总睡眠时间、睡眠效率、总非快速眼动睡眠和2期睡眠减少幅度更大。在无药患者中，精神病程度与睡眠效率、总睡眠时间和4期睡眠呈负相关。我们的数据表明，在无药患者的睡眠研究中需要明确临床状态。
