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Subjective effects of antipsychotic drugs and their relevance for compliance and remission

Published online by Cambridge University Press:  11 April 2011

Dieter Naber
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Abstract

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Only recently, success criteria became more ambitious and include a more thorough consideration of negative symptoms and cognitive dysfunction. The most important change within the last decade is the long overdue consideration of the patient's perspective. His/her subjective well-being, often unchanged or even worsened by typical antipsychotics, was neglected for a long time. One reason was the prejudice that schizophrenic patients are not able to self-rate their quality of life. Another reason was the belief that such data are not necessary because the psychiatrists' perspective, “objective” psychopathology, includes these domains. Among other scales, a self-report instrument has been constructed to evaluate “subjective well-being under neuroleptics” (SWN). This scale was used in numerous open and controlled trials, indicating: a) patients, if no longer acutely psychotic or suffering from severe cognitive deficits, are able to reliably assess their subjective well-being, b) high SWN is correlated with high compliance, c) atypical antipsychotics increase SWN, and d) individual improvements of SWN and of PANSS are not strongly related. Moreover, several studies found that early improvement of subjective well-being is a major predictor for the chance of remission. All these data indicate that a better consideration of the patient's perspective is possible and necessary.

Type
Editorials
Information
Epidemiology and Psychiatric Sciences , Volume 17 , Issue 3 , September 2008 , pp. 174 - 176
Copyright
Copyright © Cambridge University Press 2008

References

1Balestrieri, M., Giaroli, G., Mazzi, M. & Bellantuono, C. (2006). Performance of the Italian Version of the Subjective Well-being under Neuroleptic (SWN) Scale in Schizophrenic Outpatients. Pharmacopsychiatry 39, 81–84.Google Scholar
2De Haan, L., Lavalaye, J., Linszen, D., Dingemans, P.M. & Booje, J. (2000). Subjective experiences and striatal dopamine D2 receptor occupancy in patients with recent onset schizophrenia treated with olanzapine or risperidone. American Journal of Psychiatry 157, 1019–1020.Google Scholar
3De Haan, L., Weisfelt, M., Dingemans, P.M., Linszen, D.H. & Wouters, L. (2002). Psychometric properties of the subjective well-being under neuroleptics scale and the subjective deficit syndrome scale. Psychopharmacology 162, 24–28.Google Scholar
4Heinrichs, D.W., Hanlon, T.E. & Carpenter, W.T. (1984). The Quality of life scale: an instrument for rating the schizophrenic deficit syndrome. Schizophrenia Bulletin 10, 388–398.Google Scholar
5Hogan, T.P., Awad, A.G. & Eastwood, M.R. (1983). A self-report scale predictive of drug compliance in schizophrenia: reliability and discriminate validity. Psychological Medicine 13, 177–183.Google Scholar
6Karow, A. & Naber, D. (2002). Subjective well-being and quality of life under atypical antipsychotic treatment. Psychopharmacology 162, 3–10.Google Scholar
7Karow, A., Czekalla, J., Dittmann, R.W., Schacht, A., Wagner, T., Lambert, M., Schimmelmann, B.G. & Naber, D. (2007). Association of subjective well-being, symptoms, and side effects with compliance after 12 months of treatment in schizophrenia. Journal of Clinical Psychiatry 68, 75–80.CrossRefGoogle ScholarPubMed
8Lambert, M., Schimmelmann, B.G., Naber, D., Schacht, A., Karow, A., Wagner, T. & Czekalla, J. (2006). Prediction of remission as a combination of symptomatic and functional remission and adequate subjective well-being in 2960 patients with schizophrenia. Journal of Clinical Psychiatry 67, 1690–1697.CrossRefGoogle ScholarPubMed
9Lambert, M., Naber, D., Eich, F.X., Schacht, A., Linden, M. 6 Schimmelmann, B.G. (2007). Remission of severely impaired subjective wellbeing in 727 patients with schizophrenia treated with amisulpride. Acta Psychiatrica Scandinavica 115, 106–113.CrossRefGoogle ScholarPubMed
10Meltzer, H.Y., Burnett, S., Bastani, B. & Ramirez, L.F. (1990). Effects of six months of clozapine treatment on the quality of life of chronic schizophrenic patients. Hospital Community Psychiatry 41, 892–897.Google ScholarPubMed
11Mizrahi, R., Rusjan, P., Agid, O., Graff, A., Mamo, D.C., Zipursky, R.B. & naKapur, S. (2007). Adverse subjective experience with antipsychotics and its relationship to striatal and extrastriatal D2 receptors: a PET study in schizophrenia. American Journal of Psychiatry 164, 630–637.Google Scholar
12Naber, D. (1995). A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life and other clinical variables. International Clinical Psychopharmacology 10, Suppl. 3, 133–138.Google Scholar
13Naber, D. (2005). Subjective effects of antipsychotic treatment. Acta Psychiatrica Scandinavica 111, 81–83.Google Scholar
14Naber, D., Moritz, S., Lambert, M., Pajonk, F.G., Holzbach, R., Mass, R. & Andresen, B. (2001). Improvement of schizophrenic patients’ subjective well-being under atypical antipsychotic drugs. Schizophrenia Research 50, 79–88.CrossRefGoogle Scholar
15Naber, D., Riedel, M., Klimke, A., Vorbach, E.U., Lambert, M., Kühn, K.U., Bender, S., Bandelow, B., Lemmer, W., Moritz, S. & Dittmann, R.W. (2005). Randomized double blind comparison of olanzapine vs. clozapine on subjective well-being and clinical outcome in patients with schizophrenia. Acta Psychiatrica Scandinavica 111, 106–115.CrossRefGoogle ScholarPubMed
16Putzhammer, A., Perfahl, M., Pfeiff, L. & Hajak, G. (2005). Correlation of subjective well-being in schizophrenic patients with gait parameters, expertrated motor disturbances, and psychopathological status. Pharmacopsychiatry 38, 132–138.Google Scholar
17van Putten, T., May, P.R.A. & Marder, S.R. (1981). Subjective response to antipsychotic drugs. Archives of General Psychiatry 38, 187–190.CrossRefGoogle ScholarPubMed
18Voruganti, L. & Awad, A.G. (2004). Neuroleptic dysphoria: towards a new synthesis. Psychopharmacology 171, 121–132.Google Scholar
19Voruganti, K., Heslegrave, R.J., Awad, A.G. & Seeman, M.V. (1998). Quality of life measurement in schizophrenia: reconciling the quest for subjectivity with the question of reliability. Psychological Medicine 28, 165–172.CrossRefGoogle ScholarPubMed
20Voruganti, L., Cortese, L., Oyewumi, L., Cernovsky, Z., Zirul, S. & Awad, A. (2000). Comparative evaluation of conventional and novel antipsychotic drugs with reference to their subjective tolerability, sideeffect profile and impact on quality of life. Schizophrenia Research 43, 135–145.CrossRefGoogle ScholarPubMed
21Wehmeier, P.M., Kluge, M., Schneider, E., Schacht, A., Wagner, T. & Schreiber, W. (2007a). Quality of life and subjective well-being during treatment with antipsychotics in out-patients with schizophrenia. Progress in Neuropsychopharmacology & Biological Psychiatry 31, 703–712.CrossRefGoogle ScholarPubMed
22Wehmeier, P.M., Kluge, M., Schacht, A., Helsberg, K. & Schreiber, W. (2007b). Correlation of physician and patient rated quality of life during antipsychotic treatment in outpatients with schizophrenia. Schizophrenia Research 91, 178–186.Google Scholar
23Windgassen, K. (1992). Treatment with neuroleptics: the patient's perspective. Acta Psychiatrica Scandinavica 86, 405–410.Google Scholar