关键词: 精神分裂症, 焦虑, 奥氮平, 奥沙西泮, 不良反应

Abstract:

Objective To compare the therapeutic efficacy of olanzapine combined with oxazepam (combination group) and olanzapine monotherapy (monotherapy group) in patients with schizophrenia and anxiety symptoms. Methods A total of 64 female patients with schizophrenia and anxiety symptoms of our hospital from January 2020 to December 2023 were retrospectively enrolled, with 32 patients in each group. Anxiety and psychotic symptoms were assessed using the Hamilton Anxiety Rating Scale (HAMA) and the Positive and Negative Syndrome Scale (PANSS), respectively, at baseline and at weeks 2, 4, and 8. The dynamic changes in treatment efficacy, correlations between symptom improvements, differences in response and remission rates, and adverse events during treatment were compared between the two groups. Results Significant main effects of time were observed for both HAMA and PANSS total scores. A significant group×time interaction was observed for the PANSS total score, with the combination group showing superior efficacy to the monotherapy group from week 2 onward. For HAMA, only the main effect of group was significant, whereas the group×time interaction was not statistically significant. Overall, no significant correlations were observed between changes in HAMA and PANSS scores during any assessment interval, except for a weak correlation between the reduction in HAMA score and the reduction in PANSS positive-symptom score from baseline to week 2. At week 4, the anxiety response rate was higher in the combination group than in the monotherapy group (71.88% vs 25.00%). By week 8, the anxiety response rate was 100.00% in both groups, whereas only 9.38% of patients in the combination group achieved anxiety remission. There was no statistically significant difference in the incidence of adverse events between the two groups. Conclusion Olanzapine combined with oxazepam may accelerate the early improvement of psychotic symptoms and enhance the early anxiety response in patients with schizophrenia and anxiety symptoms without increasing short-term adverse events. However, its benefit for long-term complete remission of anxiety appears limited, and improvements in anxiety and psychotic symptoms appear to be relatively independent. Therefore, short-term, early, and as-needed use of oxazepam in combination with olanzapine is recommended.

Key words: schizophrenia, anxiety, olanzapine, oxazepam, adverse reactions