Cassens G, Inglis A K, Appelbaum P S, Gutheil T G
Institute of Living, Hartford, CT 06106.
Schizophr Bull. 1990;16(3):477-99. doi: 10.1093/schbul/16.3.477.
We have reviewed the literature from the 1950's to the present on the effects of neuroleptics on perceptual and neuropsychological function in chronic schizophrenic patients. In contrast to previous reviews, we have delineated the acute and chronic effects of neuroleptics on individual cognitive and motor tasks by drug, dose, and length of administration. To date, studies have shown that acute administration of neuroleptics impairs performance on some, but not all, tasks requiring vigilance and attention, and on some tasks requiring motor behavior. Chronic administration of neuroleptics, however, improves performance on some tasks requiring sustained attention and visuomotor problem-solving skills depending on dose and length of administration. Moreover, there is consistent evidence to suggest that chronic administration of neuroleptics in this patient population does not impair neuropsychological function independent of motor function. These findings have direct implications regarding the risk/benefit ratio and legal ramifications for the use of neuroleptics in chronic schizophrenic patients.
我们回顾了20世纪50年代至今关于抗精神病药物对慢性精神分裂症患者感知和神经心理功能影响的文献。与以往的综述不同，我们按药物、剂量和给药时长，阐述了抗精神病药物对个体认知和运动任务的急性和慢性影响。迄今为止的研究表明，急性给予抗精神病药物会损害部分（但并非全部）需要警觉和注意力的任务，以及一些需要运动行为的任务的表现。然而，长期服用抗精神病药物，根据剂量和给药时长，会改善一些需要持续注意力和视觉运动问题解决能力的任务的表现。此外，有一致的证据表明，在该患者群体中，长期服用抗精神病药物不会独立于运动功能而损害神经心理功能。这些发现对于抗精神病药物在慢性精神分裂症患者中的使用风险/效益比和法律后果具有直接影响。
