Soares K V, McGrath J J
Dov Hoz Street, 27/16, Kfar Saba, ISRAEL, 44356.
Cochrane Database Syst Rev. 2001(1):CD000206. doi: 10.1002/14651858.CD000206.
Tardive dyskinesia (TD) is a potentially disfiguring movement disorder of the orofacial region often caused by use of neuroleptic drugs. A wide range of strategies has been used to help manage TD and, for those who are unable to have their antipsychotic medication stopped or substantially changed, the calcium-channel blocking group of drugs (diltiazem, nifedipine, nimodipine, verapamil) has been suggested as a useful adjunctive treatment.
To determine the effects of calcium-channel blocker drugs (diltiazem, nifedipine, nimodipine, verapamil) for treatment of neuroleptic-induced TD in people with schizophrenia, schizoaffective disorder or other chronic mental illnesses.
Electronic searches of Biological Abstracts (1982-2000), Cochrane Library (Issue 4, 2000), Cochrane Schizophrenia Group's Register of trials (November 2000), EMBASE (1980-2000), LILACS (1982-2000), MEDLINE (1966-2000), PsycLIT (1974-2000), and SCISEARCH were undertaken. References of all identified studies were searched for relevant citations. Principal authors of trials were contacted.
Randomised clinical trials comparing calcium-channel blockers to placebo or no intervention for people with both TD and schizophrenia or serious mental illness were reliably selected.
Data were to have been independently extracted and analysed on an intention-to-treat basis. The relative risk (RR) and 95% confidence intervals (CI) of homogeneous dichotomous data were to have been calculated using a random effects model, and, where possible, the number needed to treat calculated. Weighted mean differences (WMD) were to have been calculated for continuous data.
No trials were included. Seven studies were excluded; five were not randomised and two small randomised crossover studies provided no usable data. Two more small randomised controlled trials await assessment. The authors have been contacted for relevant information.
REVIEWER'S CONCLUSIONS: Based on currently available information, no confident statement can be made about the effectiveness of calcium-channel blockers for treating people with neuroleptic-induced tardive dyskinesia. Before evaluation of these drugs in larger randomised controlled trials, clinicians should carefully weigh up the possible benefits against their potential adverse effects.
迟发性运动障碍（TD）是一种口面部区域潜在毁容性的运动障碍，常由使用抗精神病药物引起。人们已采用多种策略来帮助管理TD，对于那些无法停用或大幅改变抗精神病药物的患者，钙通道阻滞剂类药物（地尔硫䓬、硝苯地平、尼莫地平、维拉帕米）已被建议作为一种有用的辅助治疗方法。
确定钙通道阻滞剂类药物（地尔硫䓬、硝苯地平、尼莫地平、维拉帕米）对精神分裂症、分裂情感性障碍或其他慢性精神疾病患者中抗精神病药物所致TD的治疗效果。
对《生物学文摘》（1982 - 2000年）、Cochrane图书馆（2000年第4期）、Cochrane精神分裂症研究组试验注册库（2000年11月）、EMBASE（1980 - 2000年）、LILACS（1982 - 2000年）、MEDLINE（1966 - 2000年）、PsycLIT（1974 - 2000年）和SCISEARCH进行了电子检索。对所有已识别研究的参考文献进行了检索以获取相关引用文献。还联系了试验的主要作者。
可靠地选取了比较钙通道阻滞剂与安慰剂或不进行干预，针对同时患有TD和精神分裂症或严重精神疾病患者的随机临床试验。
数据本应基于意向性分析进行独立提取和分析。同质二分数据的相对风险（RR）和95%置信区间（CI）本应使用随机效应模型进行计算，并在可能的情况下计算所需治疗人数。对于连续数据本应计算加权平均差（WMD）。
未纳入任何试验。排除了7项研究；5项未随机分组，2项小型随机交叉研究未提供可用数据。另外2项小型随机对照试验有待评估。已联系作者获取相关信息。
基于目前可得的信息，无法就钙通道阻滞剂治疗抗精神病药物所致迟发性运动障碍患者的有效性做出肯定的陈述。在这些药物于更大规模的随机对照试验中进行评估之前，临床医生应仔细权衡其可能的益处与潜在的不良反应。
