Bartels M
Psychiatrische Universitaetsklinik, Tuebingen, Germany.
Keio J Med. 1992 Jun;41(2):59-63. doi: 10.2302/kjm.41.59.
The practice of pharmacotherapy of schizophrenia in Germany is based both on clinical experience and research findings. Experience and studies emphasize that neuroleptic medication is severely limited by side effects including acute extrapyramidal syndromes and tardive dyskinesia. Comparing neuroleptic doses in both acute and maintenance therapy have clinicians encouraged to evaluate methods for treating patients with the lowest effective dose. Other studies have shown that the plasma level may be helpful when deciding which is the best treatment for the illness. More precise results for determining the optimum dose of antipsychotic compounds in the future may be available from positron emission tomography (PET), and from fluorine-magnetic-resonance spectroscopy (FMRS). The management of patients whose illness are refractory to conventional neuroleptics is also discussed. Benzamides and clozapine, both atypical neuroleptics, may be more effective than other available compounds for the severely ill, or for patients who are unable to tolerate the neurological side effects of typical neuroleptics.
德国精神分裂症药物治疗的实践基于临床经验和研究结果。经验和研究强调，抗精神病药物受到包括急性锥体外系综合征和迟发性运动障碍在内的副作用的严重限制。比较急性和维持治疗中的抗精神病药物剂量后，临床医生受到鼓励去评估用最低有效剂量治疗患者的方法。其他研究表明，在决定哪种治疗方法对该疾病最佳时，血浆水平可能会有所帮助。未来，正电子发射断层扫描（PET）和氟磁共振波谱（FMRS）可能会提供更精确的结果来确定抗精神病化合物的最佳剂量。文中还讨论了对传统抗精神病药物难治的患者的管理。苯甲酰胺和氯氮平这两种非典型抗精神病药物，对于重症患者或无法耐受典型抗精神病药物神经副作用的患者，可能比其他现有化合物更有效。
