한국형 정신분열병 약물치료 알고리듬의 임상 적용 가능성(Ⅳ)： 과거 항정신병약물 치료력이 약물 효과 및 알고리듬 적용에 미치는 영향

Abstract

Objective：The Korean Medication Algorithm for the Treatment of Schizophrenia was developed by the extensive review and questionnaires. To evaluate the impact of a history of antipsychotic treatments on clinical response and algorithm application, using the data derived from the feasibility study of the Medication Algorithm for patients with schizophrenia. Method：Outcomes of treatment with the Medication Algorithm for 108 schizophrenics up to 4 months are presented. Measures of changes included clinical symptoms, functioning, and side effects. Comparison was done between patients with and without a history of antipsychotic treatments. Results：100 individuals (with a history=71；without a history=29) were analyzed for the comparison. Most of subjects without a history of antipsychotic treatments were administered on risperidone in the initial treatment. When compared with the subjects with a treatment history, the subjects without a history showed better treatment effects on clinical symptoms at the first evaluation. At 4-month, there were similar effects between the two groups except negative symptoms, in which the group with a history showed significantly more improvement than without a history. There were no significant differences in assessment of subjective opinion and well-being to drugs and quality of life, and objective evaluation of drug side effects. Among the subjects with a history, the ones starting with stage 1 showed higher positive symptoms, anxiety scores, and briefer duration of antipsychotic exposure than the ones starting with stage 2 or more advanced. Conclusion：This study suggests that despite some limitation, an antipsychotic treatment history may have an impact on application of medication algorithm and these data will be helpful for revision of the Medication Algorithm for the Treatment of Schizophrenia.