Psychiatry Department, Hôpital St Antoine, APHP, Université Paris 6, INSERM U538, CHU St. Antoine, Paris, France.
Curr Med Res Opin. 2010 Apr;26(4):787-801. doi: 10.1185/03007990903576953.
Restoration of quality of life is considered as the ultimate treatment goal in the management of schizophrenia and is important for destigmatising the disease. However, few studies, including the most recent, have collected quality of life data prospectively or evaluated the relationship of treatment with quality of life.
Amisulpride is an atypical antipsychotic drug which has been described to have potency in improving negative symptoms of chronic schizophrenia and whose use is associated with a relatively low rate of emergence of extrapyramidal side-effects. These properties may contribute to a beneficial effect on quality of life. A systematic literature review of functional outcome in clinical trials with amisulpride was performed in order to assess the effect of this drug on quality of life and social functioning in patients. The Medline database was searched for all studies of amisulpride in schizophrenia which reported functional and quality of life outcomes up until 30 September 2009.
Only one dedicated study assessing functional outcome or quality of life as a primary outcome criterion was identified. This demonstrated significant improvement in subjective well-being in patients with schizophrenia initiating treatment with amisulpride, and a correlation between this improvement and amelioration of psychopathology. In addition, functional outcome rating scales were used as secondary outcome measures in eight randomised clinical trials, and two naturalistic observational studies. Amisulpride treatment was associated with improvement in functional outcome, with effect sizes that were comparable between studies. Improvements in functional outcome are consistently greater than those observed in patients treated with haloperidol and similar in magnitude to those seen with three other atypical antipsychotics, namely olanzapine, ziprasidone and risperidone. A patient-reported outcome measure was used in only one comparative study, and demonstrated perception of a superior benefit with amisulpride compared to haloperidol. These findings could to some extent be replicated in several large naturalistic studies under standard conditions of care.
The data from studies on functional outcome and subjective well-being provide consistent information supporting the use of amisulpride for the treatment of schizophrenia in order to improve social functioning, integration into the community and autonomy, which are critical for the overall quality of life of patients with schizophrenia.
生活质量的恢复被认为是精神分裂症治疗的最终目标，对于消除疾病污名化非常重要。然而，包括最近的研究在内，很少有研究前瞻性地收集生活质量数据或评估治疗与生活质量的关系。
氨磺必利是一种非典型抗精神病药物，已被描述为具有改善慢性精神分裂症阴性症状的效力，并且其使用与出现锥体外系副作用的相对低发生率相关。这些特性可能有助于对生活质量产生有益的影响。对氨磺必利临床试验中功能结果的系统文献综述进行了评估，以评估该药物对患者生活质量和社会功能的影响。在截至 2009 年 9 月 30 日的所有研究中，使用 Medline 数据库搜索了氨磺必利治疗精神分裂症的报告功能和生活质量结果的所有研究。
仅确定了一项专门评估功能结果或生活质量作为主要结果标准的研究。这表明，开始用氨磺必利治疗的精神分裂症患者的主观幸福感显著改善，并且这种改善与精神病理学的改善相关。此外，在八项随机临床试验和两项自然观察研究中，使用功能结果评定量表作为次要结果测量。氨磺必利治疗与功能结果的改善相关，研究之间的效应大小相当。功能结果的改善始终大于接受氟哌啶醇治疗的患者观察到的改善，与其他三种非典型抗精神病药物（即奥氮平、齐拉西酮和利培酮）观察到的改善相当。只有一项比较研究使用了患者报告的结果测量，并且与氟哌啶醇相比，氨磺必利的优越性得到了感知。这些发现可以在标准护理条件下的几项大型自然研究中在一定程度上得到复制。
关于功能结果和主观幸福感的研究数据提供了一致的信息，支持使用氨磺必利治疗精神分裂症，以改善社会功能、融入社区和自主性，这对精神分裂症患者的整体生活质量至关重要。
