Intervention Review

Amphetamines for schizophrenia

  1. Sue Nolte1,*,
  2. David Wong2,
  3. Gary Latchford3,
  4. Owen Boyle4,
  5. Adaeze Anaenugwu5

Editorial Group: Cochrane Schizophrenia Group

Published Online: 20 JAN 2010

Assessed as up-to-date: 25 APR 2004

DOI: 10.1002/14651858.CD004964

Database Title

Additional Information

How to Cite

Nolte S, Wong D, Latchford G, Boyle O, Anaenugwu A. Amphetamines for schizophrenia. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD004964. DOI: 10.1002/14651858.CD004964.

Author Information

  1. 1

    Bridge House, Adult Psychology Service, Leeds, West Yorkshire, UK

  2. 2

    University of Leeds, Department of Psychiatry and Behavioural Sciences, Leeds, UK

  3. 3

    University of Leeds, Leeds Institute of Health Sciences, Leeds, West Yorkshire, UK

  4. 4

    Leeds, West Yorkshire, UK

  5. 5

    Duncan Macmillan House, Division of Psychiatry, Nottingham, UK

*Sue Nolte, Adult Psychology Service, Bridge House, Balm Road, Leeds, West Yorkshire, LS10 2TP, UK. suenolte@hotmail.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 20 JAN 2010

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

It is estimated that between 10% and 65% of people with schizophrenia use illicit drugs such as amphetamines. This group have an increased rate of hospitalisation, homelessness, unemployment and suicide compared with those with schizophrenia who do not abuse drugs.

Objectives

To evaluate the effects of amphetamines for people with schizophrenia in terms of clinically meaningful outcomes, cognitive functioning and physiological tests.

Search methods

We searched the Cochrane Schizophrenia Group's Register (February 2002).

Selection criteria

We included all randomised controlled trials investigating the effects of amphetamines on people with schizophrenia, compared with a placebo intervention.

Data collection and analysis

Working independently, we selected and critically appraised studies, extracted data and analysed on an intention-to-treat basis. Where possible and appropriate we calculated risk ratios (RR) and their 95% confidence intervals (CI), with the number needed to treat (NNT). For continuous data we calculated Weighted Mean Differences (WMD).

Main results

We included four short studies with a total of 83 participants. Data were few and poorly reported. The results indicated a reduction of negative symptoms for people allocated to amphetamines (n = 16, 1 RCT, WMD -3 CI -5.02 to -0.98). No such effect was found for positive symptom change (n = 16, 1 RCT, WMD 0 CI -4.46 to 4.46). Compared with placebo, amphetamines significantly increased metabolism in the left and right cerebellum (n = 23, 1 RCT, WMD 0.12 CI 0.06 to 0.18; n = 23 1 RCT, WMD 0.12 CI 0.06 to 0.18) and left striatum (n = 23, 1 RCT, WMD 0.14 CI 0.00 to 0.28) and also significantly decreased metabolism in the left dorsolateral prefrontal cortex (n = 23, 1 RCT, WMD -0.09 CI -0.17 to -0.01).

Authors' conclusions

Understandably amphetamines are rarely formally evaluated in randomised studies and therefore unpublished work in this area is likely to exist. Addition of more studies may clarify reasons why people with schizophrenia persist in taking these harmful stimulants.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Amphetamines for schizophrenia

We undertook this review with an aim to summarise randomised experimental research findings concerning the effects of amphetamines on people with schizophrenia. Most of the potentially relevant data were unusable hence it is impossible to draw firm conclusions. The findings of one small short study suggested that amphetamines may cause a reduction of the apathy and lack of energy which is often associated with schizophrenia, and this could explain why those with schizophrenia persist in taking these potentially damaging drugs.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

Amphetamines治療精神分裂症

估計約有10%到65%精神分裂症患者使用非正規藥物如amphetamines.此類藥物使用者比起非使用者,其住院率,無家可歸率,失業率和自殺率皆增加.

目標

評估amphetamines對精神分裂症患者的臨床顯著結果,認知功能和心理測驗療效

搜尋策略

搜尋 Cochrane Schizophrenia Group's Register (February 2002).

選擇標準

納入隨機對照試驗比較amphetamines和安慰劑對精神分裂症患者療效

資料收集與分析

獨立選擇評估試驗,擷取並分析意圖治療病人資料,可行則計算RR和95%CI和需要治療人數. 計算連續資料的加權平均差.

主要結論

納入4試驗共83位受試者. 沒什麼資料且報告撰寫不良,但結果顯示amphetamines組病人的負向症狀減少 (樣本數為16, 1個隨機對照試驗, 加權平均差 −3 CI −5.02 to −0.98). 但對正向症狀沒有如此影響 (樣本數為16, 1個隨機對照試驗, 加權平均差 0 CI −4.46 to 4.46). 和安慰劑相比, amphetamines顯著增加左右小腦代謝 (樣本數為23,1個隨機對照試驗, 加權平均差 0.12, CI 0.06 to 0.18)且左紋狀體代謝(樣本數為23, 1個隨機對照試驗, 加權平均差0.14 CI 0.00 to 0.28); 也顯著增加左背外側前額葉皮層代謝(樣本數為23, 1個隨機對照試驗, 加權平均差 −0.09 CI −0.17 to −0.01).

作者結論

很少隨機試驗正式評估amphetamines,因此可能有此領域的未發表文章. 需要更多試驗了解為何精神分裂症患者堅持使用這些有害刺激物

翻譯人

本摘要由成功大學附設醫院尹子真翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

我們想回顧關於精神分裂症患者使用amphetamine效果的隨機實驗性研究. 可能大部分有關資料都沒發表所以無法得到強力結論. 一個小規模研究顯示amphetamines可減少冷漠和活力缺乏等精神分裂症相關症狀. 這可以解釋為何精神分裂症患者堅持使用這些可能有害的葯物

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