Effects of Trihexyphenidyl Discontinuation on Cognitive Function, Quality of Life and Psychological Symptoms in Schizophrenia: A Randomized Control Trial
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Abstract
Objective: To determine the effect of trihexyphenidyl discontinuation on cognitive function, quality of life and psychological symptoms in schizophrenia patients Method: This study was a randomized control trial comparing the treatment group with trihexyphenidyl discontinuation by tapering off 25% of original dose per month, with the control group who continued trihexyphenidyl use at Nong Song Hong Hospital. Assessment of outcomes was conducted using 4 instruments including 1) The Montreal Cognitive Assessment (MoCA) Thai version 2) The Thai version of the brief form of the WHO Quality of Life 3) the Brief Psychiatric Rating Scale for and 4) the Modified Simpson Angus Scale for abnormal movement assessment. The study followed the patients for 20 weeks. Results: A total of 34 subjects were divided into 16 patients in the treatment group and 18 patients in the control group. The average trihexyphenidyl dose was 4.13 ± 3.56 mg/day and 5.50 ± 3.85 mg/day, respectively (P>0.05). Most of the patients were treated with first generation antipsychotics. After intervention for 20 weeks, total MoCA score in the treatment group significantly improved for 2.63 points [95%CI 1.46, 3.80]. Social relationships domain in quality of life scale of the treatment group improved more than that in the control group at week 20th (12.06 ± 2.17, 9.72 ± 2.61, respectively; P=0.008). The total psychological symptom scores of both groups significantly improved with the reduction of score from 26.06 ± 9.71 to 19.56 ± 2.61 in the treatment group (P=0.003). There was no statistically significant difference in the incidence of extrapyramidal symptoms (EPS) between group (P>0.05). Conclusion: Trihexyphenidyl discontinuation improved cognitive function, quality of life in the social relationship domain and psychological symptoms. All subjects in the treatment group were safe and EPS was rare.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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