Past Issues

Sleep Measures of Patients with Schizophrenia Treated with Risperidone, Clozapine, or Haloperidol

Yu-San Chang, M.D., M.S., Ching-Yu Lin, B.A., Mei-Yueh Chen, B.A., Ming-Chao Chen, M.D., M.S.

Objective: In this cross-sectional observational study, we intended to compare
objective and subjective sleep measures in schizophrenic patients treated with
clozapine, risperidone or haloperidol. Methods: We used polysomnography and
the Chinese version of Pittsburgh Sleep Quality Index (CPSQI) scores, to compare
schizophrenic patients receiving risperidone (n=15), haloperidol (n=13) and
clozapine (n=12). All patients were diagnosed according to the DSM-IV criteria,
and clinical symptoms were evaluated by Brief Psychiatric Rating Scale (BPRS).
Results: No signifi cant differences were found in the comparison of three treatment
groups in demographic characteristics, antipsychotic potency, the BPRS
scores and CPSQI and its sub-factors. Compared to the clozapine treated group,
both haloperidol- and risperidone- treated group had a signifi cantly less stage 2
sleep and less stable non-REM sleep (stage 2, 3 and 4). Only patients treated with
haloperidol showed signifi cantly more stage 1 sleep than the clozapine-treated
group. Conclusions: Signifi cant differences were not found in subjective perceptions
of sleep quality among schizophrenic patients treated with clozapine, risperidone
or haloperidol. Clozapine was found to induce enhancement of non-REM
sleep, especially an increase of stage 2 sleep. The D4 and the 5-HT receptor antagonist
affi nities of clozapine contribute to most of its clinical properties on sleep.
Larger patient samples, longitudinal design, and baseline recordings are needed in
future studies to confi rm of this cross-sectional observational study
Key Word antipsychotics, polysomnography, schizophrenia
Editorial Committe, Taiwanese Journal of Psychiatry
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