Sha'ar Menashe Mental Health Center, Mobile Post Hefer 38814, Israel.
Expert Rev Pharmacoecon Outcomes Res. 2002 Aug;2(4):347-56. doi: 10.1586/14737167.2.4.347.
Schizophrenia is the most chronic and disabling of mental illnesses and it imposes a disproportionately large economic burden on society. In addition to symptom reduction and cost-effectiveness, quality of life is becoming a critical outcome measure for the efficacy of antipsychotic agents in the treatment of schizophrenia patients. This review concentrates on the influences of antipsychotic agents and their side effects on quality of life of schizophrenia patients. Of the 182 papers elicited in a comprehensive Medline search from 1996-2002, we found only 21 significant papers (11.5%) reporting findings concerning the effect of antipsychotic agents on quality of life of schizophrenia patients. Very few studies directly examined the impact of side effects on quality of life ratings of schizophrenia patients. To date, there is no clear evidence that in the long-term, atypical antipsychotics are more effective or are better tolerated than typical antipsychotics. This review suggests that side effects of antipsychotic agents influence subjective quality of life of schizophrenia patients significantly less than clinical and psychosocial factors. The patient's subjective response to side effects of medication is more predictive of quality of life than the number of those effects. We discuss both patients' and clinicians' perceptions of side effects and quality of life, which should be considered in the evaluation of the efficacy of antipsychotic agents.
精神分裂症是最慢性和致残的精神疾病之一，它给社会带来了不成比例的巨大经济负担。除了减少症状和成本效益外，生活质量正在成为评估抗精神病药物治疗精神分裂症患者疗效的关键指标。这篇综述集中讨论了抗精神病药物及其副作用对精神分裂症患者生活质量的影响。在对 1996 年至 2002 年进行的全面 Medline 搜索中，我们共找到了 182 篇论文，其中只有 21 篇（11.5%）重要论文报告了抗精神病药物对精神分裂症患者生活质量的影响。很少有研究直接考察副作用对精神分裂症患者生活质量评分的影响。迄今为止，尚无明确证据表明，在长期治疗中，非典型抗精神病药物比典型抗精神病药物更有效或更耐受。这篇综述表明，抗精神病药物的副作用对精神分裂症患者的主观生活质量的影响明显小于临床和社会心理因素。患者对药物副作用的主观反应比副作用的数量更能预测生活质量。我们讨论了患者和临床医生对副作用和生活质量的看法，这应该在评估抗精神病药物的疗效时加以考虑。
