Gardos G
McLean Hospital, Belmont, Massachusetts, USA.
Drug Saf. 1999 Feb;20(2):187-93. doi: 10.2165/00002018-199920020-00007.
Antipsychotic-induced tardive dyskinesia is a common and clinically significant hazard of long term antipsychotic therapy. The arrival of atypical antipsychotics has markedly improved the outlook: atypical antipsychotics are emerging as effective treatments and may also reduce the prevalence and incidence of tardive dyskinesia. In mild cases, careful monitoring of tardive dyskinesia by serial Abnormal Involuntary Movements Scale (AIMS) assessments may be the appropriate course. More severe tardive dyskinesia calls for intervention in order to treat the dyskinesia. Atypical antipsychotics and tocopherol (vitamin E) are effective and generally well tolerated treatment options for tardive dyskinesia. Tardive dyskinesia variants such as tardive dystonia and tardive akathisia tend to be more severe and difficult to treat compared with typical tardive dyskinesia. Prevention of tardive dyskinesia is possible through careful selection of patients for antipsychotic therapy, use of the lowest effective antipsychotic dosages, use of atypical rather than traditional antipsychotics and concurrent tocopherol administration. The clinician can now undertake the management of tardive dyskinesia with growing confidence.
抗精神病药物所致迟发性运动障碍是长期抗精神病药物治疗常见且具有临床意义的危害。非典型抗精神病药物的出现显著改善了预后：非典型抗精神病药物正成为有效的治疗方法，还可能降低迟发性运动障碍的患病率和发病率。对于轻度病例，通过连续异常不自主运动量表（AIMS）评估仔细监测迟发性运动障碍可能是合适的做法。更严重的迟发性运动障碍则需要进行干预以治疗运动障碍。非典型抗精神病药物和生育酚（维生素E）是治疗迟发性运动障碍有效且一般耐受性良好的治疗选择。与典型的迟发性运动障碍相比，迟发性肌张力障碍和迟发性静坐不能等迟发性运动障碍变体往往更严重且更难治疗。通过谨慎选择接受抗精神病药物治疗的患者、使用最低有效抗精神病药物剂量、使用非典型而非传统抗精神病药物以及同时给予生育酚，可以预防迟发性运动障碍。临床医生现在可以更有信心地对迟发性运动障碍进行管理。
