Acosta Francisco J, Chinea Eugenio, Hernández José L, Rodríguez Fernando, García-Bello Miguel, Medina Gema, Nieves Wilson
Francisco J. Acosta, Mental Health Research Program, Service of Mental Health, General Health Care Programs Direction, Canary Health Service , Gran Canaria , Spain.
Nord J Psychiatry. 2014 Apr;68(3):180-8. doi: 10.3109/08039488.2013.790475. Epub 2013 May 15.
Enhanced functionality is a major goal in the treatment of schizophrenia. However, possible differences in the effectiveness of first- vs. second-generation antipsychotics or between depot/long-acting injectable (D/LAI) vs. D/LAI plus oral antipsychotics are not clear.
This study was designed to evaluate possible differences between the effects of different antipsychotic treatment types or regimens on the functionality of patients with schizophrenia.
85 outpatients with schizophrenia, who were being treated with D/LAI antipsychotics--co-administered or not with oral antipsychotics--and had been adherent to the treatment during the previous year were evaluated. Socio-demographic, clinical, treatment-related, global severity and functionality variables were evaluated. Patients were grouped according to the type of antipsychotic drug (first- vs. second-generation) or according to the co-administration (or not) of oral antipsychotics.
No differences were found between first- and second-generation antipsychotics in terms of global functionality. Patients treated with LAI risperidone showed better global functionality and better performance in their habitual social activities and personal-social relationships than patients treated with risperidone plus oral second-generation antipsychotics. Better functionality was also found to be associated with higher education level, paranoid subtype of schizophrenia, harmful use of nicotine, adherence to oral treatment and absence of concomitant oral anticholinergic or psychopharmacological treatment.
Our results suggest that D/LAI antipsychotic treatments should be administered in monotherapy whenever possible and that the treatment schedule should be simple, in order to achieve better functionality.
增强功能是精神分裂症治疗的主要目标。然而，第一代与第二代抗精神病药物的疗效差异，或长效注射剂（D/LAI）与D/LAI加口服抗精神病药物之间的疗效差异尚不清楚。
本研究旨在评估不同抗精神病治疗类型或方案对精神分裂症患者功能的影响差异。
对85例正在接受D/LAI抗精神病药物治疗（无论是否联合口服抗精神病药物）且在上一年坚持治疗的精神分裂症门诊患者进行评估。评估社会人口统计学、临床、治疗相关、整体严重程度和功能变量。患者根据抗精神病药物类型（第一代与第二代）或是否联合口服抗精神病药物进行分组。
第一代和第二代抗精神病药物在整体功能方面没有差异。与接受利培酮加口服第二代抗精神病药物治疗的患者相比，接受长效注射利培酮治疗的患者在整体功能以及日常社交活动和个人-社会关系方面表现更好。还发现更好的功能与更高的教育水平、精神分裂症的偏执型、尼古丁有害使用、口服治疗依从性以及未同时使用口服抗胆碱能或精神药物治疗有关。
我们的结果表明，D/LAI抗精神病药物治疗应尽可能采用单一疗法，且治疗方案应简单，以实现更好的功能。
