Korean J Schizophr Res.  2012 Oct;15(2):99-105. 10.16946/kjsr.2012.15.2.99.

Psychomotor Performance Relevant to Driving Ability in Patients with Schizophrenia Treated with Haloperidol and Aripiprazole

Affiliations
  • 1Department of Psychiatry, Seoul National Hospital, Seoul, Korea.
  • 2Department of Mental Health Research, Seoul National Hospital, Seoul, Korea. swroh@korea.kr
  • 3Ansan Yoon Neuropsychiatric Clinic, Ansan, Korea.
  • 4Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Abstract


OBJECTIVES
This study aimed to compare psychomotor performance related with automobile driving in patients with schizophrenia under the treatment of a typical antipsychotic agent, haloperidol, or an atypical antipsychotic agent, aripiprazole.
METHODS
We evaluated driving ability of schizophrenia patients by using the cognitive perceptual assessment for driving (CPAD). Twelve patients receiving haloperidol monotherapy and 18 taking aripiprazole monotherapy participated in this study and the results of CPAD were compared with each other.
RESULTS
Of 30 participants, 15 (50%) of the patients passed the CPAD to be regarded as competent to drive, 3 (10%) of the patients failed the CPAD considered to be severely impaired. Controlling for sex, age, education, duration of illness, there were no significant differences in the CPAD results between two treatment groups. We observed a trend that patients who received aripiprazole showed a higher total score of the CPAD than haloperidol-treated patients (55.2+/-4.9 vs. 45.7+/-8.4, p=0.080).
CONCLUSION
There were no significant differences in the psychomotor performance relevant to driving ability between haloperidol and aripiprazole groups. But our results suggest that aripiprazole might have the neurocognitive advantage over haloperidol. Future study with a large sample size and diverse antipsychotics is warranted.

Keyword

Schizophrenia; Haloperidol; Aripiprazole; Driving; Psychomotor performance

MeSH Terms

Antipsychotic Agents
Automobile Driving
Haloperidol
Humans
Imidazoles
Nitro Compounds
Piperazines
Psychomotor Performance
Quinolones
Sample Size
Schizophrenia
Aripiprazole
Antipsychotic Agents
Haloperidol
Imidazoles
Nitro Compounds
Piperazines
Quinolones

Figure

  • Fig. 1 Global driving ability of schizophrenia patients.


Reference

1. Velligan DI, Miller AL. Cognitive dysfunction in schizophrenia and its importance to outcome: the place of atypical antipsychotics in treatment. J Clin Psychiatry. 1999. 60:25–28.
2. Nuechterlein KH, Barch DM, Gold JM, Goldberg TE, Green MF, Heaton RK. Identification of separable cognitive factors in schizophrenia. Schizophr Res. 2004. 72:29–39.
Article
3. Green MF. What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry. 1996. 153:321–330.
Article
4. Marshall SC, Molnar F, Man-Son-Hing M, Blair R, Brosseau L, Finestone HM, et al. Predictors of driving ability following stroke: a systematic review. Top Stroke Rehabil. 2007. 14:98–114.
Article
5. Koh ES, Lee JI, Park SJ, Park SW, Han JH, Roh SW. Application of cognitive perceptual assessment for driving in patients with schizophrenia. Korean J Schizophr Res. 2010. 13:133–140.
6. Soyka M, Winter C, Kagerer S, Brunnauer M, Laux G, Möller HJ. Effects of haloperidol and risperidone on psychomotor performance relevant to driving ability in schizophrenic patients compared to healthy controls. J Psychiatr Res. 2005. 39:101–108.
Article
7. Brunnauer A, Laux G, Zwick S, David I, Schmauss M, Messer TH, et al. Mobility behaviour of patients with mental illness. Dtsch Z Nervenheilkd. 2008. 27:suppl. 120–121.
8. Edlund MJ, Conrad C, Morris P. Accidents among schizophrenic outpatients. Compr Psychiatry. 1989. 30:522–526.
Article
9. Harvey PD, Keefe RSE. Studies of cognitive change in patients with schizophrenia following novel antipsychotic treatment. Am J Psychiatry. 2001. 158:176–184.
Article
10. Gallhofer B, Bauer U, Lis S, Krieger S, Gruppe H. Cognitive dysfunction in schizophrenia: comparison of treatment with atypical antipsychotic agents and conventional neuroleptic drugs. Eur Neuropsychopharmacol. 1996. 6:Suppl 2. S13–S20.
Article
11. Grabe H, Wolf T, Grätz S, Laux G. The Influence of clozapine and typical neuroleptics on information processing of the central nervous system under clinical conditions in schizophrenic disorders: implications for fitness to drive. Neuropsychobiology. 1999. 40:196–201.
Article
12. Kagerer S, Winter C, Möller C, Soyka M. Effects of haloperidol and atypical neuroleptics on psychomotor performance and driving ability in schizophrenic patients. Neuropsychobiology. 2003. 47:212–218.
Article
13. Brunnauer A, Laux G, Zwick S. Driving simulator performance and psychomotor functions of schizophrenic patients treated with antipsychotics. Eur Arch Psychiatry Clin Neurosci. 2009. 259:483–489.
Article
14. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th edition, text revision. Washington, DC: American Psychiatric Press.
15. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987. 13:261–276.
Article
16. Chouinard G, Margolese HC. Manual for the extrapyramidal symptom rating scale (ESRS). Schizophr Res. 2005. 76:247–265.
Article
17. Lee JW, Jang SJ, Kim DA, Park SW, Jung WK, Yoo JH, et al. Development and application of cognitive perceptual assessment for driving of people with brain injury: comparison with cognitive behavioral driver's inventory. J Korean Acad Rehabil Med. 2004. 28:523–531.
18. Kim MU, Kim C, Kwon KD. 2003. Report on verification study of restandardization and predictive validation of driving aptitude test. Seoul: Seoul National University.
19. Engum ES, Cron L, Hulse CK, Pendergrass M, Lambert W. Cognitive behavioral driver's inventory. Cognit Rehabil. 1988. 6:34–50.
20. Choi SW, Jang SJ, Park SW, Lee JT, Park OT. Application of cognitive perceptual assessment for driving (CPAD) for the brain injured patients: a preliminary study. J Korean Acad Rehabil Med. 2008. 32(3):273–279.
21. Brunnauer A, Laux G, Geiger E, Moeller HJ. The impact of antipsychotics on psychomotor performance with regards to car driving skills. J Clin Psychopharmacol. 2004. 24:155–160.
Article
22. Burris KD, Molski TF, Xu C, Ryan E, Tottori K, Kikuchi T, et al. Aripiprazole, a novel antipsychotic, is a high-affinity partial agonist at human dopamine D2 receptors. J Pharmacol Exp Ther. 2002. 302:381–389.
Article
23. Jordan S, Koprivica V, Chen R, Tottori K, Kikuchi T, Altar CA. The antipsychotic aripiprazole is a potent, partial agonist at the human 5-HT1A receptor. Eur J Pharmacol. 2002. 441:137–140.
Article
24. Shapiro DA, Renock S, Arrington E, Chiodo LA, Liu LX, Sibley DR, et al. Aripiprazole, a novel atypical antipsychotic drug with a unique and robust pharmacology. Neuropsychopharmacology. 2003. 28:1400–1411.
Article
25. Kern RS, Green MF, Cornblatt BA, Owen JR, McQuade RD, Carson WH, et al. The neurocognitive effects of aripiprazole: an open-label comparison with olanzapine. Psychopharmacology. 2006. 187:312–320.
Article
26. Levoyer D, Drapier D, Fadier-Salicé G, Millet B. Clinical impact of aripiprazole in patients suffering from schizophrenia. Encephale. 2007. 33(3 Pt 1):332–338.
Full Text Links
  • KJSR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr