抗精神病药对脑结构的影响

目的 探讨抗精神病药对脑结构的影响。方法 回顾性分析比较了340例CT正常和79例CT诊断为脑皮质体积缩小的精神分裂症患者的发病年龄、病程、家族史、查CT前不同时段的抗精神病药用量、住院次数等变量。另外比较了40例接受2次C-r检查的精神病患者查CT前的用药情况。结果 Logistic回归分析显示，发病年龄、查CT前2个月氯氮平用量、查CT前6个月普通抗精神病药用量和舒必利用量是脑皮质体积缩小的危险因素。3例有脑皮质体积缩小者减药6个月以上后脑皮质萎缩恢复。结论 除疾病本身以外，大剂量抗精神病药与部分精神分裂症患者的脑皮质体积缩小有关联，减药一段时间后。相应的脑皮质缩小可恢复。

The effect of antipsychotics on brain structure.

Objective To explore the effect of antipsychotics on brain structure. Methods Three hundreds and forty schizophrenics with normal CT scan and 79 schizophrenics with reduced frontal and temporal volume in CT scan were compared retrospectively on the dosages of different antipsychotics in different periods prior to CT scan, age of illness onset, course of illness, family history and the number of times for hospitalization. The effect of antipsychotics on brain structure was also analyzed in another 40 psychotic patients who received twice CT scan with 9 months to 5 years intervals. Results Logistic regression analysis showed that age of illness onset, the dosage of clozapine in a period of 2 months prior to CT scan and the dosage of neuroleptics and sulpiride in a period of 6 months prior to CT scan were risk factors for reduced frontal and temporal volume in CT scan. Of 40 psychotic patients receiving twice CT scans, 3 patients had an improvement in the second CT scan than in the first CT scan after discontinuation or reducing the dosage of antipsychotics for more than 6 months. Conclusion In addition to disease perse, high dosage of antipsychotic drug is correlated with brain structure changes in some patients and those changes can recover after reducing the dosage of antipsychotics for a period of time.