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几种抗精神病药物的处方模式会影响日本慢性精神分裂症患者的认知功能。

Several prescription patterns of antipsychotic drugs influence cognitive functions in Japanese chronic schizophrenia patients.

机构信息

Department of Psychiatry, University of Occupational and Environmental Health Japan, School of Medicine, Kitakyushu, Japan.

出版信息

Int J Psychiatry Clin Pract. 2012 Jun;16(2):138-42. doi: 10.3109/13651501.2011.631018. Epub 2011 Dec 5.

Abstract

OBJECTIVE

We hypothesized that an excessive dose of antipsychotic drug and/or a larger number of antipsychotic drug worsens cognitive functions in schizophrenia patients. To confirm the hypothesis, we compared several cognitive functions in the patients taking a second-generation antipsychotic drug (SGA) only (SGA monotherapy group) with those in patients taking more than two kinds of antipsychotic drugs (polypharmacy group).

METHODS

The cognitive functions of 136 chronic schizophrenia patients were evaluated using the Brief Assessment of Cognition in Schizophrenia, Japanese-language version (BACS-J).

RESULTS

A significantly negative correlation was found between the composite score in the BACS-J and the chlorpromazine equivalence of doses of antipsychotic drugs in whole patients (r = -0.43, P < 0.001). Schizophrenia patients in the polypharmacy group had lower composite scores than those in the SGA monotherapy group in the BACS-J. No difference was observed in the composite score and the primary score in each item in the BACS-J between patients with first- plus second-generation antipsychotic drug (FGA + SGA group) and those with two kinds of SGA (SGA + SGA group).

CONCLUSION

These results suggest that an excessive dose of antipsychotic drugs regardless of FGA and SGA might cause the deterioration of cognitive functions in chronic Japanese schizophrenia patients.

摘要

目的

我们假设抗精神病药物的过量剂量和/或更多种类的抗精神病药物会使精神分裂症患者的认知功能恶化。为了验证这一假设,我们比较了仅服用第二代抗精神病药物(SGA)的患者(SGA 单药治疗组)与服用两种以上抗精神病药物的患者(多种药物治疗组)的几种认知功能。

方法

使用日本版Brief Assessment of Cognition in Schizophrenia(BACS-J)评估了 136 例慢性精神分裂症患者的认知功能。

结果

在所有患者中,BACS-J 的综合评分与抗精神病药物氯丙嗪等效剂量之间存在显著负相关(r = -0.43,P < 0.001)。在 BACS-J 中,多种药物治疗组的综合评分低于 SGA 单药治疗组。在 BACS-J 的各项目中,使用第一代和第二代抗精神病药物(FGA + SGA 组)与使用两种 SGA(SGA + SGA 组)的患者的复合评分和主要评分无差异。

结论

这些结果表明,无论 FGA 和 SGA 如何,抗精神病药物的过量剂量都可能导致慢性日本精神分裂症患者认知功能的恶化。

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