Stip E
Centre de recherche Fernand-Seguin, Hôpital Louis-H Lafontaine, Montreal, Quebec.
Can J Psychiatry. 1996 Oct;41(8 Suppl 2):S27-34. doi: 10.1177/070674379604100822.
To describe the concept of memory impairment in schizophrenia and the clinical implications of this concept in terms of patient assessment and neuroleptic drug use.
Narrative literature review.
Individuals suffering from schizophrenia normally exhibit some degree of memory impairment. Recent work in psychopathology indicates that the impairment is comprehensive, involving the sensory, short-term, and long-term memory stores. Memory impairment appears to be a primary symptom of the disease, and its underlying causes are likely organic. A number of medications, however (for example, traditional neuroleptics and drugs that have pronounced anticholinergic activity), may cause or exacerbate impairment. In particular, anticholinergic agents used to treat extrapyramidal symptoms, a common complication of neuroleptic drugs, appear to have a deleterious effect on memory.
Memory impairment is an important consideration in the clinical assessment and management of patients with schizophrenia. The use of atypical antipsychotics like risperidone appears to have no impact on memory function; because risperidone is associated with a low incidence of extrapyramidal side effects, it can obviate the need for anticholinergic medications-thus offering greater hope of nondebilitative intervention. The advent of medications that are safer (on cognition) could also lead to generally better outcomes by facilitating compliance with drug regimens and rehabilitation programs.
描述精神分裂症中记忆损害的概念，以及该概念在患者评估和抗精神病药物使用方面的临床意义。
叙述性文献综述。
精神分裂症患者通常表现出一定程度的记忆损害。精神病理学的最新研究表明，这种损害是全面的，涉及感觉记忆、短期记忆和长期记忆存储。记忆损害似乎是该疾病的主要症状，其潜在原因可能是器质性的。然而，一些药物（例如传统抗精神病药物和具有明显抗胆碱能活性的药物）可能会导致或加重记忆损害。特别是，用于治疗锥体外系症状（抗精神病药物的常见并发症）的抗胆碱能药物似乎对记忆有有害影响。
记忆损害是精神分裂症患者临床评估和管理中的一个重要考虑因素。使用利培酮等非典型抗精神病药物似乎对记忆功能没有影响；由于利培酮与锥体外系副作用的发生率较低相关，因此可以避免使用抗胆碱能药物——从而为非致残性干预带来更大希望。安全性更高（对认知功能而言）的药物的出现，也可能通过促进患者对药物治疗方案和康复计划的依从性，带来总体上更好的治疗效果。
