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特集 統合失調症の認知機能障害の臨床的意義
統合失調症の認知機能増強薬の開発についての最近の動向
著者： 宮本聖也1
所属機関： 1聖マリアンナ医科大学神経精神科学教室
ページ範囲：P.713 - P.718
文献購入ページに移動はじめに
統合失調症の認知機能障害(cognitive impairment associated with schizophrenia；CIAS)は，陰性症状とともに患者の社会的・職業的機能転帰に大きく影響するunmet medical needsの一つであり，近年は治療上の重要な標的となっている24,25,26)。第2世代抗精神病薬(second-generation antipsychotics；SGAs)は，当初CIASに対する効果が期待されたが，第1世代抗精神病薬(first-generation antipsychotics；FGAs)の効果と比較した多数の臨床試験のメタ解析の結果，そのeffect size(ES)は0.24と小さく，認知機能の改善効果には限界があることが判明した32)。そこで米国を中心に，認知機能を改善させる効果を持つ薬剤(認知機能増強薬あるいは認知機能改善薬)を開発するプロジェクトが企画され，これまで多数の薬剤が開発され臨床試験が実施されてきた。本稿では，認知機能増強薬の開発についての最近の動向と今後の課題を述べたい。
統合失調症の認知機能障害(cognitive impairment associated with schizophrenia；CIAS)は，陰性症状とともに患者の社会的・職業的機能転帰に大きく影響するunmet medical needsの一つであり，近年は治療上の重要な標的となっている24,25,26)。第2世代抗精神病薬(second-generation antipsychotics；SGAs)は，当初CIASに対する効果が期待されたが，第1世代抗精神病薬(first-generation antipsychotics；FGAs)の効果と比較した多数の臨床試験のメタ解析の結果，そのeffect size(ES)は0.24と小さく，認知機能の改善効果には限界があることが判明した32)。そこで米国を中心に，認知機能を改善させる効果を持つ薬剤(認知機能増強薬あるいは認知機能改善薬)を開発するプロジェクトが企画され，これまで多数の薬剤が開発され臨床試験が実施されてきた。本稿では，認知機能増強薬の開発についての最近の動向と今後の課題を述べたい。
参考文献
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