15,35-37 The total score, as well as the subscales were only moderately correlated with the PANSS scores (r=-0.1 to -0.5) with stronger
relationships to the negative and global score than to the positive score. The highest correlations (r=-0.4 to -0.5) were related to the severity of depression and anxiety. Regarding the impact of side effects, Lambert et al38 found, in a study in 213 patients treated with typical neuroleptics, that sexual dysfunctions and extrapyramidal and psychic side effects were Inhibitors,research,lifescience,medical rated as subjectively more distressing than vegetative side effects and sedation. In a study by de Haan et al39 it was shown that dosage of medication leading to dopamine (D2) receptor blockade should be carefully evaluated, since it is most likely responsible Inhibitors,research,lifescience,medical for neuroleptic dysphoria, even in the absence of motor side effects:40,41 The relationship between SWN and striatal D2 receptor occupancy was investigated in 22 schizophrenic patients, clinically stable under either 14.7 mg of olanzapine or 4.1 mg of risperidone. It was demonstrated that in the absence of extrapyramidal symptoms, higher striatial D2-receptor occupancy as measured by single photon-emission
computed tomography (SPECT) was related to reduced SWN, negative symptoms, and depression (P<0.01). Atypical antipsychotics, subjective well-being, and compliance Inhibitors,research,lifescience,medical Naber15 investigated the subjective perception of neuroleptic treatment with the SWN and found it to be significantly related to noncompliance. Forty-eight patients rated their SWN prior to discharge from inpatient treatment. Six months Inhibitors,research,lifescience,medical later, 14 patients were noncompliant. Compared with 34 patients who remained compliant, their SWN at discharge was significantly lower (P<0.05). However, the psychiatrists did not see a difference between future compliant or Inhibitors,research,lifescience,medical noncompliant patients; the PANSS scores did not differentiate between both groups. In another patient population,
it was shown that the SWN of 28 patients treated with the atypical antipsychotic clozapine because of therapy resistance or motor side effects was, despite negative selection, significantly better than the SWN score of 38 patients under classical neuroleptics (P=0.03). In a later study, olanzapine and clozapine were compared in SPTLC1 a double-blind, controlled trial in 114 patients, over a 26-week period.37 Regarding SWN, the total BYL719 research buy score-as well as all subscores, excluding mental functioning-showed a significant relationship between low SWN and noncompliance (P<0.005 – P<0.01). Again, this study showed that the improvement of SWN and of PANSS are not strongly related (r=-0.3 to -0.4). The SOHO study also found a relevant relationship between subjective well-being and compliance. It is a 3-year investigation of the health outcomes associated with antipsychotic treatment in Europe.
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