Schulz S Charles
Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minn 55454-1495, USA.
J Clin Psychiatry. 2002;63 Suppl 13:32-8.
Although quetiapine was introduced as an atypical antipsychotic drug with clinical efficacy in schizophrenia patients, it has been used in a variety of disease states over the last 5 years. The most common conditions have included mood and anxiety disorders, obsessive-compulsive disorder, aggression, hostility, posttraumatic stress disorder, borderline personality disorder, delirium, and comorbid substance abuse. Considering its efficacy in a wide variety of neuropsychiatric conditions and its excellent tolerability profile, quetiapine could emerge as a broad-spectrum psychotropic medication that may be helpful in psychiatry across various diagnostic categories. Traditionally, studies on the predictive validity of psychiatric disorders help with nosologic issues and controversies. Assessing quetiapine's tolerability and its overall treatment response might help tease out the predictive validity of various psychiatric syndromes (based currently on an atheoretical descriptive approach) and may shape psychiatric nosology in the future. Quetiapine's low affinity and fast dissociation from postsynaptic dopamine-2 receptors give the least risk of producing acute extrapyramidal side effects, tardive dyskinesia, and neuroleptic malignant syndrome. These factors suggest that the clinical utility of quetiapine in psychiatric conditions other than schizophrenia has not been fully exploited thus far.
尽管喹硫平作为一种对精神分裂症患者有临床疗效的非典型抗精神病药物被引入，但在过去5年中它已被用于多种疾病状态。最常见的病症包括情绪和焦虑障碍、强迫症、攻击性、敌意、创伤后应激障碍、边缘性人格障碍、谵妄以及合并物质滥用。鉴于其在多种神经精神疾病中的疗效以及出色的耐受性，喹硫平可能会成为一种广谱精神药物，对各个诊断类别的精神病学都有帮助。传统上，关于精神疾病预测效度的研究有助于解决分类学问题和争议。评估喹硫平的耐受性及其总体治疗反应可能有助于梳理各种精神综合征的预测效度（目前基于一种无理论的描述性方法），并可能在未来塑造精神病学分类学。喹硫平与突触后多巴胺-2受体的低亲和力和快速解离使其产生急性锥体外系副作用、迟发性运动障碍和抗精神病药恶性综合征的风险最小。这些因素表明，喹硫平在精神分裂症以外的精神疾病中的临床效用迄今尚未得到充分利用。
