Wolf M A, Bailly L, Diener J M, Martinet J P, Peretti S, Garneau Y
Centre de recherche Université Laval Robert-Giffard, Beauport, (Québec), Canada.
Encephale. 1991 Jul-Aug;17(4):255-61.
We report 2 studies evaluating the effects of a complete and progressive neuroleptic withdrawal on the symptomatology of 2 groups of 10 young chronically ill schizophrenic inpatients. In a preliminary open study, we compare the psychiatric symptomatology during a 4-week-period before the beginning of withdrawal and during a similar period following the end of withdrawal. We observe the significative improvement of the blunted affect, the deterioration of an aspecific psychiatric symptomatology (including irritability, excitement, hostility) and the non-modification of the specific schizophrenic symptomatology (in its 3 main components: positive signs, negative signs, disorganization). The second study (a double blind one) reports the effects of a complete neuroleptic withdrawal maintained during a longer period (8 weeks): 1. The improvement of the blunted affect is transiently observed during the 2 first weeks after the end of withdrawal but not after this time. 2. The deterioration of the aspecific psychiatric symptomatology by opposition to the non-significative modification of the specific schizophrenic symptomatology is a fact confirmed by this second study. Even if we can not exclude that the influence of neuroleptic withdrawal on the specific psychotic symptoms may require a longer time frame than 8 weeks to detect, this dichotomic evolution raises the problem of the specific action of neuroleptics in this particular category of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
我们报告了两项研究,评估完全且逐步停用抗精神病药物对两组各10名慢性患病的年轻精神分裂症住院患者症状学的影响。在一项初步的开放性研究中,我们比较了停药开始前4周期间和停药结束后类似时间段内的精神症状学。我们观察到情感迟钝有显著改善,非特异性精神症状(包括易怒、兴奋、敌意)恶化,而特异性精神分裂症症状(其三个主要成分:阳性症状、阴性症状、紊乱)未改变。第二项研究(双盲研究)报告了较长时间(8周)维持完全停用抗精神病药物的效果:1. 在停药结束后的头两周内短暂观察到情感迟钝有所改善,但此后未再出现。2. 第二项研究证实了非特异性精神症状恶化,而特异性精神分裂症症状无显著改变这一事实。即使我们不能排除停用抗精神病药物对特异性精神病症状的影响可能需要超过8周的时间才能检测到,但这种二分法演变提出了抗精神病药物在这类特定患者中的具体作用问题。(摘要截选至250字)