A Comparison Between Effects Of Two Types Of Antipsychotic Maintenance Treatment On Outcome In Patients With Schizophrenia

Objective This research set a comparison between two types of antipsychotic drugs,to further find the difference between effects of two types of antipsychotic maintenance treatment on outcome about efficacy,life quality,social function and the safety in patients with schizophrenia,Finally,represented by social function,we explore the influence factors of social function.Methods First of all,on the basis of the set of conditions,we screened the patients with schizophrenia who leave the Seventh People’s Hospital of Hangzhou,in June to December in 2009.460 cases of patients with schizophrenia were divided into typical drug group and the atypical drug group according to the types of antipsychotic drugs used,and the numbers are 250 cases and 210 cases respectively,then the patients were arranged to complete a follow-up of five years,we paid close attention to the categories and the dosage of the two types of antipsychotics;In the baseline period,the second and the fifth year of the follow-up,the efficacy,quality of life,social function and safety of two groups assessed with the positive and negative symptoms scale(PANSS),quality of life scale(QOL),personal and social performance scale(PSP)and treatment emergent symptom scale(TESS);Finally,the influence factors of the social function were analyzed by Correlation analysis and Multiple regression analysis.Results 1.A total of 205 patients finished the follow-up,including 95 cases in the typical group and 110 cases in the atypical group,in the typical group,the detailed categories and dosage of typical antipsychotics was: 67 cases of chlorpromazine(185±65.7 mg),20 cases of sulpiride(0.48±0.2 g),9 cases of perphenazine(13.1±5.6mg),6 cases of haloperidol(7.7±6.6 mg),5 cases of penfluridol(28±11.0 mg/week).in the atypical group,the detailed categories and dosage of atypical antipsychotics was: 27 cases of risperidone(3.9±1.2 mg),38 cases of clozapine(226.5±139.9 mg),25 cases of quetiapine(0.48±0.16 g),20 cases of olanzapine(15.5±6.5 mg),17 cases of aripiprazole(17.1±9.0),7 cases of ziprasidone(80±56.6),7 cases of paliperidone(5.14±1.5 mg),1 case of amisulpride(0.6 g),the expulsion of typical group was 62%,but in the atypical group was 47.6%;2.Results of the PANSS scale indicate: compare to the baseline period,the PANSS scores in two groups were lower in the second year and the fifth year,and the difference was statistically significant(P<0.01),but wasn’t between the two groups beside the negative scores,the affective symptoms and the cognitive factor of PANSS(P< 0.01);3.QOL scale results showed that scores in the second year and the fifth year were lower than baseline period,and the difference has statistical significance(P< 0.01).in the second year or the fifth year,the QOL scores in atypical group are lower than that in typical group,and the difference has statistical significance(P < 0.01);4.PSP scores in the second year and the fifth year were higher than baseline period,but statistically difference only appear in the atypical group.(P<0.01);5.TESS scale results show that drowsiness,acute dystonia,parkinsonism syndrome,akathisia,tardive dyskinesia,dry mouth/constipation happened more frequently in the typical group,but the rising of prolactin,blood glucose,blood fat,and weight happened more frequently in the atypical group;6.Correlation analysis suggests the PSP scores was positively correlated with marriage,education,and occupation and medication adherence and negatively correlated with the duration,hospitalized times,PANSS and TESS points.Multiple regression analysis results indicate the main factors influencing the PSP scores were PANSS cognitive factor,TESS,PANSS negative factor,duration,hospitalization times and total scores of PANSS.Conclusion1.The drug therapy compliance in the atypical group is better than typical group,so is long-term medication rate;2.Compared to the typical antipsychotics,the atypical antipsychotics had the same curative effect;3.Atypical antipsychotics can improve the negative symptoms,emotional symptoms,cognitive function,quality of life and social function of schizophrenia patients,and much safer;4.Appropriate drugs,good drug therapy compliance,harmonious and fulfilling marriage,education and occupation environment can improve patients’ social function.