Depressive Signs and Symptoms in Schizophreniaстатья из журнала
Аннотация: Background: Depressive signs and symptoms during the course of schizophrenia are common and have been associated with impaired recovery and a higher risk of self-harm.Novel antipsychotic agents introduce new pharmacological avenues that may differentially affect schizophrenic signs and symptoms, including depression.Methods: This was a 17-country investigation of 1996 patients with schizophrenia or a related diagnosis randomly assigned to a blinded, comparative trial of the novel antipsychotic agent olanzapine (5-20 mg/d) or the conventional D 2 antagonist haloperidol (5-20 mg/d).Patients were evaluated with the Positive and Negative Syndrome Scale, the Montgomery-Asberg Depression Rating Scale, and the Simpson-Angus Rating Scale.The trial consisted of a 6-week and a 46-week masked responder maintenance period.Results: At least moderate depressive signs and symptoms (Montgomery-Asberg Depression Rating Scale score, Ն16) were seen in slightly more than half of this sample.Although both treatments were associated with short-term baseline-to-end point improvement on the Montgomery-Asberg Depression Rating Scale, olanzapineassociated improvements were significantly superior to those observed with haloperidol (P=.001).Furthermore, the response rate for the group receiving olanzapine (Ն50% improvement on the Montgomery-Asberg Depression Rating Scale after at least 3 weeks of treatment) was also significantly higher (P=.008).Analysis demonstrated that improvement in positive, negative, and/or extrapyramidal symptoms was associated with mood improvement (indirect effect); however, most of the olanzapine treatment effect on mood was a primary direct effect (57%) that alone was significantly greater than that seen with haloperidol treatment (PϽ.001).Conclusions: Depressive signs and symptoms in schizophrenia are responsive to treatment.The pleotrophic pharmacological features of olanzapine, through 1 or more non-D 2 -mediated pathways, likely contribute to its superior treatment effect.Better control of the mood disorders accompanying schizophrenia holds the possibility for improved patient outcomes.
Год издания: 1998
Авторы: Gary D. Tollefson, T.M. Sanger, Yili Lu, Martha E. Thieme
Издательство: American Medical Association
Источник: Archives of General Psychiatry
Ключевые слова: Schizophrenia research and treatment, Mental Health and Psychiatry, Psychosomatic Disorders and Their Treatments
Другие ссылки: Archives of General Psychiatry (HTML)
PubMed (HTML)
PubMed (HTML)
Открытый доступ: closed
Том: 55
Выпуск: 3
Страницы: 250–250