Rémillard Sophie, Pourcher Emmanuelle, Cohen Henri
Cognitive Science Institute, Université du Québec à Montréal, Montreal, Canada.
J Int Neuropsychol Soc. 2008 Jan;14(1):110-8. doi: 10.1017/S1355617708080090.
There is evidence in the literature that cognitive functions in schizophrenia (SC) may be improved by atypical neuroleptics (NLPs) in contrast to typical medication, but there is still controversy regarding this apparent superiority of atypical drugs. In this study, we assessed the differential effects of risperidone and haloperidol on verbal memory, attention, and psychiatric symptoms in SC. The performance of 28 SC participants, randomly assigned to risperidone (2-6 mg/day) or haloperidol (2-40 mg/day), was compared with that of healthy controls. The California Verbal Learning Test (CVLT), the d2 Cancellation Test, and the Positive and Negative Symptoms Scale were administered at baseline and 3, 6, and 12 months. Relative to controls, all SC participants showed markedly impaired verbal memory and processing speed at each assessment period. There was no differential effect between the two NLPs on CVLT and d2 performance. However, risperidone was more effective than haloperidol in reducing psychiatric symptoms. Improvement in symptom severity was not associated with improvement in neurocognitive performance on these specific tests. Neither conventional nor atypical neuroleptic medications improved neurocognitive functioning over a 12-month follow-up, suggesting that psychopathological improvement under risperidone is independent of cognitive function.
文献中有证据表明，与传统药物相比，非典型抗精神病药物（NLPs）可能会改善精神分裂症（SC）的认知功能，但对于非典型药物的这种明显优势仍存在争议。在本研究中，我们评估了利培酮和氟哌啶醇对SC患者言语记忆、注意力和精神症状的不同影响。将28名SC参与者随机分为利培酮组（2 - 6毫克/天）或氟哌啶醇组（2 - 40毫克/天），并将他们的表现与健康对照组进行比较。在基线以及3个月、6个月和12个月时进行加利福尼亚言语学习测试（CVLT）、d2删除测试和阳性与阴性症状量表评估。相对于对照组，所有SC参与者在每个评估期的言语记忆和处理速度均明显受损。两种NLPs对CVLT和d2测试表现没有差异影响。然而，利培酮在减轻精神症状方面比氟哌啶醇更有效。症状严重程度的改善与这些特定测试中神经认知表现的改善无关。在12个月的随访中，传统和非典型抗精神病药物均未改善神经认知功能，这表明利培酮治疗下的精神病理学改善与认知功能无关。
