Original article

Korean Journal of Schizophrenia Research 2005;8(2):54-63.

외래치료 중인 정신분열병 환자에서 리스페리돈, 올란자핀 및 할로페리돌에 대한 주관적 반응

윤보현·윤진상·배안·시영화·이태성

Abstract

Objective: There has been a growing need not only to establish the therapeutic superiority of atypical antipsychotics over the typical antipsychotic drugs, but also to explore the differential effectiveness of various individual compounds. The outcome measures were meant to reflect patients’ perspective, and were broad in their scope including symptoms, side-effects and quality of life measures. This study compared the effectiveness of atypical and typical antipsychotic drugs from a patient’s perspective. Method: Ninety patients meeting selection criteria and receiving risperidone (N=30), olanzapine (N=30) and haloperidol (N=30) for a period of 6 months or longer were included. They were all stabilized outpatient clinic attendees. Demographic and clinical data were compared between the three medication groups using various rating scales: the Positive and Negative Syndrome Scale (PANSS), 10-items of Drug Attitude Inventory (DAI-10), Extrapyramidal Symptom Rating Scale (ESRS), UKU side effect rating scale, 10-items of Korean modified version of Subjective Wellbeing under Neuroleptic treatment (KmSWN- 10), Quality of Life scale of General Health Questionnaire (GHQ/QL-12) and Global Assessment of Functioning scale (GAF). Analysis of variance and multiple regression analysis were applied.
Results:Patients receiving olanzapine were younger and had shorter total duration of illnesses. Also they showed shorter duration of current antipsychotic medication than those of haloperidol. Patients’ perceived economic status were significantly differed among the groups. Although there were no differences on scores of the UKU rating scale, KmSWN-10, GHQ/QL-12, and GAF between the three medication groups, patients receiving olanzapine showed less severe psychopathology on the positive, general psychopathology, and total scores of PANSS. Only the patients receiving olanzapine showed better scores on the positive subjective feelings and the final score of DAI-10 than those of haloperidol. These effects were still present after controlling the variables such as age, duration of illness and duration of current medication as the covariates. Self-perceived economic status, KmSWN-10, type of antipsychotics and dyskinesia scale of ESRS had significant effects on DAI.
Conclusion:Although olanzapine showed the favorable outcomes especially on the aspects of subjective experiences or tolerability, these results suggest that we may not conclude the general notion that the novel antipsychotics are uniformly better tolerated as indicated by the measures of subjective responses, side effects, and a subjective quality of life in schizophrenic outpatients. Socioeconomic variables in addition to psychopathology, side effects and QoL may also be important factors to evaluate the patient’s subjective aspects. (Schizophrenia Clinics 2005;8:54-63)

Key Words: Subjective response·Drug attitude inventory·Quality of life·Antipsychotic drugs·Schizophrenia