Evaluation of paliperidone on social function in patients with chronic schizophrenia

Background The impairment of social function is widespread in the patients with chronic schizophrenia, which seriously affects family, life and work conditions.Aims The main purpose of this study was to investigate the efficacy of paliperidone in the treatment of social function in chronic schizophrenia.Methods A total of 81 patients who met the standard criteria for schizophrenia and long-term hospitalised inpatients were randomly divided into the treatment group and normal control group following a 1-year prospective follow-up study. The reatment group(41 cases) used paliperidone extended-release tablets for reducing dosage, as appropriate, based on the original treatment strategy; and the control group(40 cases) used the former drugs. All patients were assessed using the Positive and Negative Symptom Scales(PANSS), and the Treatment Emergent Symptom Scale(TESS) was used to assess adverse drug reactions. The Hospitalised Psychiatric Patients' Social Functions Rating Scale(SSPI) was used to assess social function of participants before and after 8 weeks, 6 months and 1 year of treatment.Results At baseline there were no significant differences between the two groups in age, duration of illness, educational background and dosage of antipsychotic drugs(converted into chlorpromazine equivalency). There was statistically significant difference in PANSS positive symptoms by interaction effect(Fgroup×time=18.24, df=3237, p<0.001) and time effect(Ftime=21.66, df=3, p<0.01) and the difference in PANSS positive symptoms by grouping effect(Fgroup=0.68, df=1, p=0.41) was not statistically significant. The difference of grouping effect of PANSS negative symptoms(Fgroup=9.93, df=1, p=0.002), time effect(Ftime=279.15, df=3, p<0.001) and interaction effect(Fgroup×time=279.15, df=3237, p<0.001) were statistically significant. There were statistically significant differences in the grouping effect(Fgroup=6.59, df=1, p=0.012), time effect(Ftime=152.97, df=3, p<0.001) and interaction effect(Fgroup×time=148.82, df=3237, p<0.001) of PANSS general pathological symptoms, the same as the total score of the PANSS, which showed large differences in grouping effect(Fgroup=7.04, df=1, p=0.001), time effect(Ftime=210.78, df=3, p<0.001) and interaction effect(Fgroup×time=205.20, df=3237, p<0.01). We found in the total SSPI score, grouping effect(Fgroup=31.70, df=1, p<0.001), time effect(Ftime=161.84, df=3, p<0.001) and interaction effect(Fgroup×time=132.74, df=3237, p<0.001) were demonstrated to be significantly different. Even though adverse reactionsoccurred 7 times in the treatment group and 44 times in the control group based on the Treatment Emergent Symptom Scale(TESS), incidence rate was significantly lower than that of the control group(χ2=18.854, p<0.001).Conclusion Paliperidone can safely and effectively improve negative symptoms and social function in patients with chronic schizophrenia.

A meta-analysis of phlegm-resolving Chinese medicine combined with risperidone for treatment of schizophrenia

Objective:The efficacy and occurrence of adverse reactions of prescriptions containing phlegm-resolving Chinese medicine combined with risperidone in the treatment of schizophrenia were retrospectively studied by means of meta-analysis.Methods:A variety of different Chinese and English databases were searched from January 1,2000 to May 1,2020.Review Manager 5.3 software was used to evaluate the methodological quality of the included studies.The positive and negative symptom scale(PANSS)was used as the evaluation standard to analyze the total scores,positive scores,negative scores and general psychopathological scores,clinical efficacy and safety of prescriptions containing phlegmresolving Chinese medicine combined with risperidone of schizophrenia.The heterogeneity test and sensitivity analysis were also carried out by Review Manager 5.3,and the potential publication bias was analyzed by"funnel plot".Results:A total of 1515 patients were included in 15 studies.Compared with control group of risperidone alone,the total PANSS scale score,positive symptom score,negative symptom score and general psychopathological score of the treatment group of phlegm-resolving Chinese medicine combined with risperidone were all lower than those of the control group(P=0.01,MD=-6.35,95%CI[-11.29,-1.40]),(P=0.04,MD=-1.42,95%CI[-2.74,-0.09]),(P<0.01,MD=-2.16,95%CI[-3.41,-0.91]),and(P<0.01,MD=-3.80,95%CI[-6.37,-1.24]),the clinical efficacy of phlegm-resolving Chinese medicine combined with risperidone treatment group on schizophrenia was better than that of the control group[P<0.01,RR=1.09,95%CI(1.05-1.13)].The incidence of adverse reactions was reduced(P=0.02,RR=0.56,95%CI[0.34-0.93]).Conclusion:The combination of prescriptions containing phlegm-resolving Chinese medicine and risperidone can effectively improve the efficacy of patients with schizophrenia and reduce the occurrence of adverse drug reactions compared with risperidone alone.