Schubert Max H, Young Keith A, Hicks Paul B
Department of Psychiatry and Behavioral Science, Neuropsychiatry Research Program, Texas A&M University System Health Science Center College of Medicine, Central Texas Veterans Health Care System, Temple, Texas, USA.
Biol Psychiatry. 2006 Sep 15;60(6):530-3. doi: 10.1016/j.biopsych.2006.04.006. Epub 2006 Jun 27.
Cognition in schizophrenia is impaired in a variety of cognitive domains. Galantamine, a cholinesterase inhibitor with putative nicotinic agonist-like effects, improves cognition in Alzheimer's patients.
Sixteen schizophrenic or schizoaffective patients stabilized on risperidone were administered galantamine (n=8) or placebo (n=8) in a randomized, double-blind trial. The Repeatable Battery for Assessment of Neuropsychological Status (RBANS) assessed changes in cognitive performance over an eight-week treatment interval.
Clinical symptoms improved in both groups during the trial with no evidence that galantamine exacerbated extrapyramidal symptoms. Patients treated with galantamine experienced an overall improvement in cognitive performance (RBANS Total scale score; galantamine = 12.1 +/- 12.8 SD, placebo = .5 +/- 13.5, t = 2.32, p < .04). Confidence intervals suggest that RBANS Attention and Delayed Memory subscale performance was robustly improved in galantamine patients by approximately one standard deviation, effectively normalizing cognitive performance in these domains.
Adjunctive treatment with galantamine improves memory and attention in patients with schizophrenia who are stabilized on risperidone, providing the opportunity to improve functional outcome in these patients.
精神分裂症患者在多种认知领域存在认知功能受损。加兰他敏是一种具有假定烟碱样激动剂作用的胆碱酯酶抑制剂,可改善阿尔茨海默病患者的认知功能。
在一项随机双盲试验中,对16例使用利培酮病情稳定的精神分裂症或分裂情感性障碍患者给予加兰他敏(n = 8)或安慰剂(n = 8)治疗。采用可重复神经心理状态评估量表(RBANS)评估八周治疗期间认知表现的变化。
试验期间两组临床症状均有改善,没有证据表明加兰他敏会加重锥体外系症状。接受加兰他敏治疗的患者认知表现总体改善(RBANS总量表评分;加兰他敏组 = 12.1 ± 12.8标准差,安慰剂组 = 0.5 ± 13.5,t = 2.32,p < 0.04)。置信区间表明,加兰他敏组患者的RBANS注意力和延迟记忆子量表表现显著改善约一个标准差,有效使这些领域的认知表现恢复正常。
对于使用利培酮病情稳定的精神分裂症患者,加用加兰他敏可改善记忆和注意力,为改善这些患者的功能结局提供了机会。