Rappaport M, Hopkins H K, Hall K, Belleza T, Silverman J
Int Pharmacopsychiatry. 1978;13(2):100-11. doi: 10.1159/000468327.
This study reports that there are schizophrenics who do relatively well long term without the routine or continuous use of antipsychotic medication. Specially selected young males undergoing an acute schizophrenic episode were followed, after hospitalization, for up to three years. While hospitalized they were assigned randomly to either placebo or chlorpromazine treatment. Many unmedicated-while-in-hospital patients showed greater long-term improvement, less pathology at follow-up, fewer rehospitalizations and better overall function in the community than patients who were given chlorpromazine while in the hospital. Factors related to post-hospital outcome were good premorbid history and short-lived paranoid characteristics. Considerations which may have an effect on the successful management of acute schizophrenic patients not on medication are mentioned. The findings underline the need for further study of how to utilize antipsychotic medication more selectively in the treatment of schizophrenia.
本研究报告称,有些精神分裂症患者在长期不常规或持续使用抗精神病药物的情况下表现相对良好。对经过特别挑选的、正在经历急性精神分裂症发作的年轻男性,在住院后进行了长达三年的跟踪随访。住院期间,他们被随机分配接受安慰剂或氯丙嗪治疗。与住院时接受氯丙嗪治疗的患者相比,许多住院期间未用药的患者表现出更大的长期改善、随访时病理症状更少、再次住院次数更少以及在社区中的整体功能更好。与出院后结果相关的因素包括病前史良好和偏执特征短暂。文中提到了可能对未用药的急性精神分裂症患者的成功管理产生影响的因素。这些发现强调了进一步研究如何在精神分裂症治疗中更有选择性地使用抗精神病药物的必要性。