Medizinische Universität Innsbruck, Innsbruck, Austria.
J Clin Psychopharmacol. 2021;41(4):389-396. doi: 10.1097/JCP.0000000000001403.
Most studies investigating antipsychotic effectiveness report either total psychopathology or symptom cluster findings. Studies focusing on a separate symptom, such as hallucinations, a hallmark symptom in schizophrenia, are scarce.Therefore, the current study aims to compare the antihallucinatory effectiveness of 3 pharmacologically different antipsychotics: olanzapine, amisulpride, and aripiprazole.
The present study is part of the Bergen-Stavanger-Innsbruck-Trondheim study, a 12-month prospective, randomized, pragmatic antipsychotic drug trial in active-phase schizophrenia spectrum disorders. The primary outcome of the present study was change of hallucinations as measured by item P3 (hallucinatory behavior) from the Positive and Negative Syndrome Scale in the subgroup with hallucinations at baseline. Primary analyses were intention to treat.
A total of 144 participants were included in the study, where 105 (72%) had a score of 3 or more on the Positive and Negative Syndrome Scale P3 item at baseline, indicating the presence of hallucinations (HALL subgroup).In the HALL subgroup, a significantly less reduction of hallucinations was revealed for participants using olanzapine in weeks 12, 26, 39, and 52 when compared with amisulpride and in weeks 26 and 52 when compared with aripiprazole. In subanalyses for participants never exposed to antipsychotic drugs (antipsychotic-naive) and those who had used antipsychotics before entering the study, antihallucinatory differences were revealed only in the latter group.
A differential antihallucinatory effect of the 3 study drugs was present. The inferior effect of olanzapine seems to be driven by the subgroup of participants exposed to antipsychotic treatment before entering the study.
大多数研究抗精神病药物疗效的报告要么是总精神病学，要么是症状群发现。专注于一种单独症状的研究很少，如幻觉，这是精神分裂症的一个标志症状。因此，目前的研究旨在比较三种药理学上不同的抗精神病药物：奥氮平、氨磺必利和阿立哌唑的抗幻觉效果。
本研究是 Bergen-Stavanger-Innsbruck-Trondheim 研究的一部分，这是一项为期 12 个月的前瞻性、随机、实用抗精神病药物治疗精神分裂症谱系障碍活动期的药物试验。本研究的主要结局是使用阳性和阴性综合征量表（PANSS）中的 P3 项目（幻觉行为）测量幻觉的变化，该项目在基线时存在幻觉的患者。主要分析是意向治疗。
共有 144 名参与者被纳入研究，其中 105 名（72%）在基线时 PANSS P3 项目得分为 3 或更高，表明存在幻觉（HALL 亚组）。在 HALL 亚组中，与氨磺必利相比，奥氮平组在第 12、26、39 和 52 周，与阿立哌唑相比在第 26 和 52 周时，参与者的幻觉减少明显较少。在从未使用过抗精神病药物的参与者（抗精神病药物未暴露）和之前使用过抗精神病药物的参与者的亚分析中，仅在后一组中发现了抗幻觉的差异。
三种研究药物的抗幻觉效果存在差异。奥氮平的效果较差似乎是由进入研究前接受过抗精神病药物治疗的参与者亚组驱动的。
