Mas Sergi, Gassó Patricia, Fernández de Bobadilla Ramón, Arnaiz Joan Albert, Bernardo Miquel, Lafuente Amalia
Department of Pathological Anatomy, Pharmacology and Microbiology, School of Medicine, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
Hum Psychopharmacol. 2013 Nov;28(6):586-93. doi: 10.1002/hup.2350. Epub 2013 Oct 7.
The effect of antipsychotics (APs) on negative symptoms is controversial. The present study assessed negative symptoms in healthy volunteers without any source of primary negative symptoms after single doses of haloperidol and risperidone.
Twenty-five healthy subjects were included in this randomized, placebo-controlled, single-dose (haloperidol 5 mg and risperidone 2.5 mg) crossover and double-blind clinical trial. Negative symptoms were assessed by observer-rated scales and with a self-report scale. Possible confounding effects considered were extrapyramidal symptoms (EPS) and sedative effects. The occupation of striatal dopamine D2 receptors was also determined.
Risperidone induced a wide range of negative symptoms such as alogia, blunted affect, avolition/apathy, and attention impairment, whereas haloperidol only induced the avolition/apathy subdomain. Most of the effects of risperidone in healthy volunteers, with the exception of its effects on avolition/apathy, were attributable to AP-induced EPS. Haloperidol did not cause significant EPS after administration. No effect of sedation or psychomotor performance was observed on negative symptoms.
Single doses of both haloperidol and risperidone induced nonmotor secondary negative symptoms in healthy volunteers. The clinical findings are especially relevant in view of the impact of negative symptoms on poor functioning. They may help to guide clinicians in their choice of APs (http://clinicaltrials.gov/ct2/show/NCT01259973).
抗精神病药物(APs)对阴性症状的影响存在争议。本研究评估了单次服用氟哌啶醇和利培酮后,无原发性阴性症状来源的健康志愿者的阴性症状。
25名健康受试者纳入了这项随机、安慰剂对照、单剂量(氟哌啶醇5毫克和利培酮2.5毫克)交叉双盲临床试验。通过观察者评定量表和自我报告量表评估阴性症状。考虑的可能混杂效应为锥体外系症状(EPS)和镇静作用。还测定了纹状体多巴胺D2受体占有率。
利培酮诱发了广泛的阴性症状,如言语减少、情感迟钝、意志缺乏/冷漠和注意力损害,而氟哌啶醇仅诱发意志缺乏/冷漠子领域症状。利培酮对健康志愿者的大多数影响,除了对意志缺乏/冷漠的影响外,都归因于AP诱发的EPS。氟哌啶醇给药后未引起明显的EPS。未观察到镇静或精神运动表现对阴性症状有影响。
单次服用氟哌啶醇和利培酮均在健康志愿者中诱发了非运动性继发性阴性症状。鉴于阴性症状对功能不良的影响,这些临床发现尤为重要。它们可能有助于指导临床医生选择APs(http://clinicaltrials.gov/ct2/show/NCT01259973)。