Seidman L J, Pepple J R, Faraone S V, Kremen W S, Green A I, Brown W A, Tsuang M T
Department of Psychiatry, Harvard Medical School, Boston, MA.
Biol Psychiatry. 1993;33(8-9):575-84. doi: 10.1016/0006-3223(93)90095-u.
The effect of 80%-90% neuroleptic dose reductions on neuropsychological function in schizophrenic and schizoaffective patients was examined in a prospective study. A neuropsychological battery was administered in the week prior to neuroleptic reduction followed by retesting at least 6 weeks postreduction. Patients were retested only if they did not relapse after reduction. The design allowed neuropsychological changes due to neuroleptic medications to be assessed independently of general clinical change. Neuropsychological performance was generally stable and unchanging. However, there was a trend toward significant improvement on a dichotic digits task based in improvement in left ear accuracy. Negative symptoms diminished after reduction. Compared with a normal control group, schizophrenics' initial laterality index showed a significantly exaggerated right ear advantage (REA); after reduction, the REA was no longer different from controls. The findings indicate that neuropsychological changes in a small sample of older nonrelapsing chronic schizophrenics are modest. The data suggest that neuroleptics may impair right hemisphere functions in some patients.
在一项前瞻性研究中，研究了将抗精神病药物剂量减少80%-90%对精神分裂症和分裂情感性障碍患者神经心理功能的影响。在减少抗精神病药物剂量的前一周进行了一套神经心理测试，然后在减少剂量至少6周后再次进行测试。只有在减少剂量后未复发的患者才会接受再次测试。该设计使得能够独立于一般临床变化来评估抗精神病药物引起的神经心理变化。神经心理表现总体上稳定不变。然而，基于左耳准确性的提高，在双耳分听数字任务上有显著改善的趋势。减少剂量后阴性症状有所减轻。与正常对照组相比，精神分裂症患者最初的偏侧性指数显示出明显夸大的右耳优势（REA）；减少剂量后，REA与对照组不再有差异。研究结果表明，一小部分老年非复发慢性精神分裂症患者的神经心理变化较小。数据表明，抗精神病药物可能会损害一些患者的右半球功能。
