Molho E S, Factor S A
Parkinson's Disease and Movement Disorder Center, Albany Medical Center, 215 Washington Ave. Extension, Albany, NY 12203, USA.
Curr Neurol Neurosci Rep. 2001 Jul;1(4):320-8. doi: 10.1007/s11910-001-0085-8.
Drug-induced psychosis is one of the most disabling complications of advancing Parkinson's disease. It has also been one of the most difficult to treat. Clozapine was the first medication shown to be safe and effective in this setting, and it remains the standard by which newer atypical antipsychotics are measured. However, due to the small but significant risk of agranulocytosis and the need for frequent blood testing, alternatives have been sought. Risperidone, olanzapine, and quetiapine are new atypical antipsychotics that have each been proposed as an alternative to clozapine, but the literature concerning their use in Parkinson's disease is conflicted and confusing. Although quetiapine appears to be the best current choice, none of these medications have equaled clozapine's ability to safely treat drug-induced psychosis without the risk of worsening parkinsonism.
药物性精神病是帕金森病进展过程中最致残的并发症之一，也是最难治疗的并发症之一。氯氮平是首个被证明在此情况下安全有效的药物，它仍是衡量新型非典型抗精神病药物的标准。然而，由于粒细胞缺乏症虽风险小但显著，且需要频繁进行血液检测，人们一直在寻找替代药物。利培酮、奥氮平和喹硫平是新型非典型抗精神病药物，每种都被提议作为氯氮平的替代品，但关于它们在帕金森病中应用的文献相互矛盾且令人困惑。尽管喹硫平似乎是目前最佳选择，但这些药物中没有一种能在不加重帕金森病的风险下，达到氯氮平安全治疗药物性精神病的能力。
