Challenge to atypical antipsychotic drug effect on cognition.
Challenge to atypical antipsychotic drug effect on cognition.
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对非典型抗精神病药物对认知的影响的挑战。
DOI：
10.1176/appi.ajp.2007.07071086
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Conley,RobertR
中科院分区：
文献类型：
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作者：
Carpenter,WilliamT;Conley,RobertR
致编辑：在2007年7月刊上，Richard SE Keefe博士等人报道了奥氮平、喹硫平和利培酮对神经认知功能的影响。Keefe等人得出结论，这三种药物都对神经认知产生了显著的改善。作者指出，认知能力的改善是适度的，但他们认为临床重要性基于0.14和0.18的相关性，与生活质量量表的一个组成部分，仅占方差的2%-3%。即使这种小的影响也不能归因于药物的功效。该研究设计不包括对照组。所研究的药物对认知有类似的效果，但我们不知道效果是更好，更差，还是与安慰剂或第一代抗精神病药物治疗相同。Keefe等人(2)发表在《普通精神病学档案》（Archives of General Psychiatry）上的一项研究表明，奥氮平、喹硫平和利培酮未能从“典型”抗精神病药物奋那嗪中分离出来，该研究使用了临床抗精神病药物干预有效性试验（CATIE）研究的认知数据。如果观察到的改善是真实的，则不能排除以下其他因果解释：1)当基线评估接近时，疾病的自然过程可能导致认知改善
TO THE EDITOR: In the July 2007 issue of the Journal, Richard SE Keefe, Ph. D., et al.(1) reported on the effects of olanzapine, quetiapine, and risperidone on neurocognitive function. Dr. Keefe et al. concluded that all three drugs produced significant improvements in neurocognition. The authors noted that cognitive improvement was modest, but they suggested clinical importance based on correlations of 0.14 and 0.18, with a component of the Quality of Life Scale, accounting for only 2%–3% of the variance. Even this small effect cannot be attributed to drug efficacy. The study design did not include a comparison group. The drugs studied had a similar effect on cognition, but we do not know whether the effect was better, worse, or the same as placebo or treatment with a first-generation antipsychotic. In a study conducted by Keefe et al.(2), published in Archives of General Psychiatry, olanzapine, quetiapine, and risperidone failed to separate from perphenazine, a “typical” antipsychotic, using cognition data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study. If the improvement observed is real, the following other causal explanations cannot be excluded: 1) The natural course of illness may lead to cognitive improvement when the baseline assessment is near the time of