Effects of antipsychotic drugs on insight in schizophrenia.
Lack of insight is predominant in schizophrenia though the causes are still unclear. The present study was carried on to investigate the effect of three Second Generation Antipsychotics (SGAs) and Haloperidol on insight and the associations among different clusters of symptoms and insight. Fifty-five patients have been recruited at the moment of pharmacological switch needed for psychotic exacerbation, from other antipsychotic drugs to Olanzapine, Aripiprazole, Ziprasidone and Haloperidol. Patients have been followed for 6 months and evaluated at baseline, after 3 months and after 6 months. Regarding the insight improvement, all SGAs resulted more effective than Haloperidol, while no difference was detected among different SGAs. Concerning psychopathology, all SGAs showed a better efficacy than Haloperidol, positive symptoms apart. All SGAs showed a similar efficacy on all domains, except for negative symptoms which resulted less responsive to ziprasidone and haloperidol. An association between improvement of insight and psychopathology was detected. Furthermore, insight appears to be related to psychopathology severity, particularly to negative symptoms. However, the observed different effectiveness of Ziprasidone on negative symptoms and insight suggests that these psychopathological features may be not strictly related and, thus, they may be sustained by different psychopathological processes.
Department of Biomedical and NeuroMotor Sciences, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy; Institute of Psychiatry, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy. Electronic address: oryb@hotmail.it.
Oriana
O
Bianchini
Department of Biomedical and NeuroMotor Sciences, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy.
Stefano
S
Porcelli
Department of Biomedical and NeuroMotor Sciences, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy.
Claudia
C
Nespeca
Institute of Psychiatry, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy.
Dario
D
Cannavò
Department of Biomedical and NeuroMotor Sciences, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy.
Angela
A
Trappoli
Institute of Psychiatry, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy.
Eugenio
E
Aguglia
Department of Biomedical and NeuroMotor Sciences, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy.
Diana
D
De Ronchi
Department of Biomedical and NeuroMotor Sciences, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy.
Alessandro
A
Serretti
D000328:Adult; D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000068180:Aripiprazole; D001364:Awareness / Q000187:drug effects*; D001569:Benzodiazepines / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D010879:Piperazines / Q000494:pharmacology / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D015363:Quinolones / Q000494:pharmacology / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D013844:Thiazoles / Q000494:pharmacology / Q000627:therapeutic use
D014150:Antipsychotic Agents; D010879:Piperazines; D015363:Quinolones; D013844:Thiazoles; D001569:Benzodiazepines; C092292:ziprasidone; D000068180:Aripiprazole; D006220:Haloperidol; D000077152:Olanzapine
Antipsychotic; Insight; Psychopathology; Schizophrenia