Comparative assessment of effect on psychomotor performance efficacy and adherence of levosulpiride and olanzapine in patients with schizophrenia: A parallel, open-label, prospective observational study

IF 0.2 Q4 PSYCHIATRY Annals of Indian Psychiatry Pub Date : 2023-10-01 DOI:10.4103/aip.aip_35_23
N. Pramoda, V. A. Turankar, M. Thakre, Sudhir Laludeo Mahajan, Sunil M. Mahakalkar, A. Shetty, Sandeep M. Sasi
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Abstract

Context: Schizophrenia is mostly treated with atypical antipsycotics, which may be required for lifetime. Olanzapine is commonly used in this condition, whereas levosulpiride is approved in India for the same. Knowing the effect of these drugs on psychomotor function helps in choosing a suitable drug to a particular patient based on his daily activities. Aims: The aim is to compare the effect of levosulpiride and olanzapine on psychomotor performance, efficacy, and adherence in patients with schizophrenia. Settings and Design: This was open-label, parallel arm, prospective observational study carried out in a tertiary care hospital of central India from December 2019 to December 2021. Subjects and Methods: Thirty-six patients visiting psychiatry OPD, diagnosed by treating psychiatrist as schizophrenia were assessed by CFFT, hand steadiness test (HST), arithmetic ability test, and reaction time (RT) for psychomotor function, and symptoms were scored on positive and negative syndrome scale (PANSS) and brief negative symptom scale (BNSS) rating scales at the first visit, end of 4 and 8 weeks. Adherence was assessed by the Medication adherence rating scale at 8 weeks. Results: Statistically significant increase in RT was seen in both levosulpiride (P = 0.04) and olanzapine (P = 0.0065) groups, whereas only the olanzapine group had a significant change in CFFT (P = 0.04) and HST (P = 0.01) at 8 weeks. On head-to-head comparison, a statistically significant worsening in HST score (P = 0.01) was seen in olanzapine group. Both the groups had significant decreases in all PANSS (P < 0.001) and BNSS (P < 0.001) scores. When change in PANSS and BNSS scores were compared with each other, the levosulpiride group had a significantly more decrease in scores on PANSS negative scale (P = 0.03). Patients in both groups were adherent to treatment. Conclusions: Our study concluded that levosulpiride is better than olanzapine on its fine motor control. Both the drugs increase RT while only olanzapine worsened fine motor control and CFF. Both the drugs were effective for schizophrenia with 8 weeks treatment, while levosulpiride is superior to olanzapine in improving negative symptoms of schizophrenia.
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比较评估左旋舒必利和奥氮平对精神分裂症患者精神运动表现疗效和依从性的影响:一项平行、开放标签、前瞻性观察研究
背景:精神分裂症大多采用非典型抗sycotics(抗精神病药物)治疗,这种药物可能需要终身使用。奥氮平是治疗这种疾病的常用药物,而左旋舒必利在印度也被批准用于治疗这种疾病。了解这些药物对精神运动功能的影响有助于根据患者的日常活动为其选择合适的药物。目的:比较左旋舒必利和奥氮平对精神分裂症患者精神运动功能、疗效和依从性的影响。设置与设计:这是一项开放标签、平行臂、前瞻性观察研究,于2019年12月至2021年12月在印度中部的一家三级医院进行。研究对象和方法:36名到精神科门诊就诊的患者,经精神科医生诊断为精神分裂症,在首次就诊、4周和8周结束时接受CFFT、手部稳定性测试(HST)、算术能力测试和反应时间(RT)评估精神运动功能,并根据阳性和阴性综合征量表(PANSS)和简短阴性症状量表(BNSS)评分表对症状进行评分。用药依从性评分量表对8周后的依从性进行评估。结果在8周时,左旋舒必利组(P = 0.04)和奥氮平组(P = 0.0065)的RT均有统计学意义的增加,而只有奥氮平组的CFFT(P = 0.04)和HST(P = 0.01)有显著变化。在组间比较中,奥氮平组的 HST 评分出现了统计学意义上的明显恶化(P = 0.01)。两组的 PANSS(P<0.001)和 BNSS(P<0.001)评分均有明显下降。如果将 PANSS 和 BNSS 分数的变化相互比较,则左旋舒必利组在 PANSS 阴性量表上的分数下降幅度更大(P = 0.03)。两组患者均坚持治疗。结论我们的研究认为,左旋舒必利在精细运动控制方面优于奥氮平。两种药物都能增加 RT,而只有奥氮平使精细运动控制和 CFF 恶化。两种药物在治疗 8 周后对精神分裂症均有效,而左旋舒必利在改善精神分裂症阴性症状方面优于奥氮平。
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自引率
25.00%
发文量
38
审稿时长
23 weeks
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