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多奈哌齐联合非典型抗精神病药物对精神分裂症患者认知功能的影响:一项开放性试验。

Effect of donepezil added to atypical antipsychotics on cognition in patients with schizophrenia: an open-label trial.

作者信息

Chung Young-Chul, Lee Chun-Rong, Park Tae-Won, Yang Keum-Hwa, Kim Ki-Won

机构信息

Department of Psychiatry, Chonbuk National University Medical School, Jeonju, South Korea.

出版信息

World J Biol Psychiatry. 2009;10(2):156-62. doi: 10.1080/15622970701432551.

Abstract

BACKGROUND

Despite the beneficial effects of atypical antipsychotics on cognition, many schizophrenic patients continue to suffer from cognitive impairment. Postmortem findings suggest that altered cholinergic activity is involved in cognitive impairment in schizophrenia.

OBJECTIVE

This study investigated whether adjunctive donepezil added to atypical antipsychotics can improve cognition in schizophrenic patients.

METHOD

We conducted an open-label trial of donepezil, at doses of up to 10 mg/day for 12 weeks, added to ongoing atypical antipsychotics in 28 stable schizophrenic patients. At baseline and 12 weeks, the patients were evaluated using the Positive and Negative Syndrome Scale (PANSS), Schizophrenia Cognition Rating Scale (SCoRS), and Computerized Neurocognitive Function Test (CNT).

RESULTS

Donepezil treatment resulted in significant improvements in attention, memory, psychomotor speed, and mental set-shifting ability.

CONCLUSIONS

Adjunctive treatment with donepezil improves cognition in patients with schizophrenia who are stabilized on atypical antipsychotics. Further studies controlling for smoking, age, and severity of cognitive impairment of the participants are needed.

摘要

背景

尽管非典型抗精神病药物对认知功能有有益影响,但许多精神分裂症患者仍存在认知障碍。尸检结果表明,胆碱能活性改变与精神分裂症的认知障碍有关。

目的

本研究调查了在非典型抗精神病药物基础上加用多奈哌齐是否能改善精神分裂症患者的认知功能。

方法

我们对28例病情稳定的精神分裂症患者进行了一项开放标签试验,在持续使用非典型抗精神病药物的基础上加用多奈哌齐,剂量最高达10毫克/天,持续12周。在基线和12周时,使用阳性和阴性症状量表(PANSS)、精神分裂症认知评定量表(SCoRS)和计算机化神经认知功能测试(CNT)对患者进行评估。

结果

多奈哌齐治疗使注意力、记忆力、精神运动速度和思维转换能力有显著改善。

结论

在使用非典型抗精神病药物病情稳定的精神分裂症患者中,加用多奈哌齐治疗可改善认知功能。需要进一步开展研究,控制参与者的吸烟情况、年龄和认知障碍严重程度。

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