Department of Psychiatry, Suzuki Clinic [H.S.] , Tokyo , Japan.
Int J Psychiatry Clin Pract. 2014 Jan;18(1):58-62. doi: 10.3109/13651501.2013.845218. Epub 2013 Nov 13.
This study was to evaluate the effects on clinical symptoms and cognitive function of switching the treatment of elderly patients with schizophrenia from risperidone to paliperidone (PAL).
This study was a 12-weeks, preliminary open-label trial. The subjects were 17 inpatients. Their extrapyramidal symptoms (EPS) were assessed using the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS), Abnormal Involuntary Movement Scale (AIMS), and Barnes Akathisia Scale (BAS), and their cognitive function was assessed using the Brief Assessment Cognition in Schizophrenia: Japanese language version (BACS-J), and their clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity of illness scale (CGI-S) at the 0 and 12 weeks.
The DIEPSS and BAS significantly improved after switching from risperidone to PAL. Furthermore, improvement was found on AIMS. The mean change from baseline in z-score of the digit sequencing task was significantly increased. All items on the PANSS and CGI-S were not significant; however, changes in some cognitive function were correlated with changes in EPS.
The results of this study suggest the possibility that switching elderly patients from risperidone to PAL may have improved pre-existing EPS, and may also have helped improve working memory.
本研究旨在评估将老年精神分裂症患者的治疗药物从利培酮转换为帕利哌酮（PAL）对临床症状和认知功能的影响。
本研究为 12 周初步开放标签试验。共纳入 17 名住院患者。采用药物诱发的锥体外系症状量表（DIEPSS）、不自主运动量表（AIMS）和巴恩斯静坐不能量表（BAS）评估锥体外系症状，采用简明精神分裂症认知评定量表：日语版（BACS-J）评估认知功能，阳性和阴性症状量表（PANSS）和临床总体印象-严重程度量表（CGI-S）评估临床症状。在第 0 和 12 周评估上述指标。
从利培酮转换为 PAL 后，DIEPSS 和 BAS 显著改善。此外，AIMS 也有所改善。数字序列任务的 z 评分的平均变化显著增加。PANSS 和 CGI-S 的所有项目均无显著差异；然而，一些认知功能的变化与 EPS 的变化相关。
本研究结果提示，将老年精神分裂症患者从利培酮转换为 PAL 可能改善了现有的锥体外系症状，并且可能有助于改善工作记忆。
