Risperidone與Haloperidol對精神分裂病患者睡眠的效應比較

Comparison of the Effects of Risperidone and Haloperidol on the Sleep of Patients with Schizophrenia

10.29478/TJP.200609.0006

張鈺姍(Yu-San Chang)；賴俊揚(Chun-Yang Lai)；吳泓機(Hung-Chi Wu)；陳明招(Ming-Chao Chen)

精神分裂病 ； 睡眠分析 ； risperidone ； haloperidol ； schizophrenia ； polysomography ； risperidone ； haloperidol

台灣精神醫學

20卷3期（2006 / 09 / 01）

212 - 220

繁體中文

Objective: The main pharmacological difference between risperidone and haloperidol is the higher potency of 5-HT2 receptor blockade by risperidone. This study compared the polysomographic patterns of schizophrenic patients treated with risperidone with those patients receiving haloperidol. The relationship between sleep architecture and clinical symptoms was also examined in these patients. Methods: 　 Sleep architectures were compared in 17 schizophrenic patients treated with risperidone and 18 schizophrenic patients treated with haloperidol. Schizophrenia was diagnosed in all patients according to DSM-IV criteria and clinical symptoms were evaluated by the Brief Psychiatric Rating Scale (BPRS). The relationships between sleep architecture and clinical symptoms were also investigated. Results: No differences between the risperidone and haloperidol group were found in demographic characteristics, dose of antipsychotic agents, sleep architecture, or BPRS scores and sub-factors. The BPRS scores and the sub-factors of positive symptoms, hostility/suspiciousness were negatively correlated with total sleep time (p＜0.05, p＜0.05, p＜0.05). The negative symptoms and slow wave sleep were inversely correlated (p＜0.05). Conclusions: Further studies are needed to determine the mechanisms by which 5-HT2 receptor antagonist affect sleep architectures. This study found that negative symptoms in schizophrenia were correlated with slow wave sleep, and psychotic exacerbation was associated with reduced total sleep time. (Full text in Chinese)

Objective: The main pharmacological difference between risperidone and haloperidol is the higher potency of 5-HT2 receptor blockade by risperidone. This study compared the polysomographic patterns of schizophrenic patients treated with risperidone with those patients receiving haloperidol. The relationship between sleep architecture and clinical symptoms was also examined in these patients. Methods: 　 Sleep architectures were compared in 17 schizophrenic patients treated with risperidone and 18 schizophrenic patients treated with haloperidol. Schizophrenia was diagnosed in all patients according to DSM-IV criteria and clinical symptoms were evaluated by the Brief Psychiatric Rating Scale (BPRS). The relationships between sleep architecture and clinical symptoms were also investigated. Results: No differences between the risperidone and haloperidol group were found in demographic characteristics, dose of antipsychotic agents, sleep architecture, or BPRS scores and sub-factors. The BPRS scores and the sub-factors of positive symptoms, hostility/suspiciousness were negatively correlated with total sleep time (p＜0.05, p＜0.05, p＜0.05). The negative symptoms and slow wave sleep were inversely correlated (p＜0.05). Conclusions: Further studies are needed to determine the mechanisms by which 5-HT2 receptor antagonist affect sleep architectures. This study found that negative symptoms in schizophrenia were correlated with slow wave sleep, and psychotic exacerbation was associated with reduced total sleep time. (Full text in Chinese)

1. American Psychiatric Association(1994).Diagnostic and statistical Manual of Mental Disorders.Washington DC:American Psychiatric Association.
2. Benca RM,Obermeyer WH,Thisted RA,Gillin JC(1992).Sleep and psychiatric disorders: a meta-analysis.Arch Gen Psychiatry,49,651-668.
3. Chouinard G,Jones B,Remington G(1993).A Canadian multicenter placebo-controlled study of fixed doses of risperidone and haloperidone in the treatment of chronic schizophrenic patients.J Clin Psychoparmacol,13,25-40.
4. Dursun SM,Patel JKM,Burke JG(1999).Effects of typical antipsychotic drugs and risperdone on the quality of sleep in patients with schizophrenia: a pilot study.J Psychiatry Neurosci,24,333-337.
5. Ganguli R,Reynolds CF,Kupfer DJ(1987).Electroencephalographic sleep in young, never-medicated schizophrenics.Arch Gen Psychiatry,44,36-44.
6. Haffmans PMJ,Ooiders JM,Hoencamp E(2001).The effect of risperidone versus haloperidol on sleep patterns od schizophrenic patients: results of a double-blind, randomized pilot trial.Eur Neuropsychopharmacol,11,260.
7. Idzikowski C,Mills FJ,Glennard R(1986).5-hydro-xytryptamine-2-antagonist increases human slow wave sleep.Brain Res,378,164-168.
8. Kaplan HI,Sadock BJ,Grebb JA,Cancro R,Gabbard GO,Jones RM (eds.)(1994).Synopsis of psychiatry.New York:Williams & Wilkins.
9. Katsuda Y,Walsh AE,Ware CJ,Cowen PJ,Sharpley AL(1993).Meta-chlorophenylpiperazine decreases slow-wave sleep in humans.Biol Psychiatry,33,49-51.
10. Kempenaers C,Kerkhofs M,Linkowski P,Mendlewicz J(1988).Sleep EEG variables in young schizophrenia and depressive patients.Biol Psychiatry,24,833-838.
11. Lee JH,Woo JI,Meltzer HY(2001).Effects of clozapine on sleep measures and sleep-associated changes in growth hormone and cortisol in patients with schizophrenia.Psychiatry Res,103,157-166.
12. Maixner S,Tandon R,Eiser A(1998).Effects of antipsychotic treatment on polysomnographic measures in schizophrenia: a replication and extension.Am J Psychiatry,155,1600-1602.
13. Monti JM,Monti D(2004).Sleep in schizophrenia patients and the effects of antipsychotic drugs.Sleep Med,8,133-148.
14. Nofzinger EA,Van Kammen DP,Gilbertson MW(1993).Electrocephalographic sleep in clinically stable schizophrenic patients: two-weeks versus six-weeks neuroleptic free.Biol Psychiatry,33,829-835.
15. Overall JE,Gorham DR(1962).The Brief Psychiatric Rating Scale.Psychol Rep,10,799-812.
16. Rechtschaffen A,Kales A.A manual of standardized terminology, techniques and scoring system for sleep stages in human subjects.Los Angeles:UCLA Brain Information Services/Brain Research Institute.
17. Salin-Pascual RJ,Herrera-Estrella M,GaliciaPolo L(1999).Olanzapine acute administration in schizophrenic patients increases delta sleep and sleep efficiency.Biol Psychiatry,46,141-143.
18. Sharpley AL,Vassalo CM,Cowen PJ(2000).Olanzapine increases slow-wave sleep: evidence for blockade of central 5-HT(2C) receptors in vivo.Biol Psychiatry,47,468-470.
19. Tandon R,Shipley JE,Taylor SF(1992).Electrocephalographic sleep abnormalities in schizophrenia: relationship to positive/negative symptoms and prior neuroleptic treatment.Arch Gen Psychiatry,49,185-194.
20. Taylor SF,Tandon R,Shipley JE(1991).Effects of neuroleptic treatment on polysomnographic measures in schizophrenia.Biol Psychiatry,30,904-912.
21. Van Kammen DP,Van Kammen WB,Peters J(1986).CSF MHPG sleep and psychosis in schizophrenia.Clin Neuropharmacol,9,575-577.
22. Van Kammen DP,Van Kammen WB,Peters J,Goetz K,Neylan T(1988).Decreased slow-wave sleep and enlarged lateral ventricles in schizophrenia.Neuropsychopharmacology,1,265-271.
23. Wetter TC,Lauer CJ,Gillich G(1996).The electrocephalographic sleep pattern in schizophrenic patients treated with clozapine or classical anti-psychotic drugs.J Psychiat Res,30,411-419.
24. Yamashita H,Morinobu S,Yamawaki S,Horiguchi J,Nagao M(2002).Effects of risperidone on sleep in schizophrenia: a comparison with haloperidol.Psychiatry Res,109,137-142.
25. Yiamashita H,Mori K,Nagao M,Okamoto Y,Morinobus S,yamawaki S(2004).Effect of changing from typical to atypical antipsychotic drugs on subjective sleep quality in patients with schizophrenia in a Japanese population.J Clin Psychiatry,65,1525-1530.
26. Zarcone V,Benson KL(1997).BPRS symptom factors and sleep vsriables in schizophrenia.Psychiatry Res,66,111-120.
27. Zarcone VP,Benson KL,Berger PA(1987).Abnormal rapid eye movement latencies in schizophrenia.Arch Gen Psychiatry,44,45-48.

1. Yu, Chen-Hua,Kao, Chin-Yi,Huang, Yu-Mei,Hsu, Jer-Hwa(2011).Analyses of the Quality of Life among Patients with Schizophrenia.台灣精神醫學,25(3),158-166.