Blair D T, Dauner A
Colmery-O'Neil Veterans Administration Medical Center, Topeka, Kan.
Nurse Pract. 1992 Nov;17(11):56, 62-4, 67. doi: 10.1097/00006205-199211000-00018.
Antipsychotic medications commonly produce extrapyramidal symptoms as side effects. The extrapyramidal symptoms include acute dyskinesias and dystonic reactions, tardive dyskinesia, Parkinsonism, akinesia, akathisia, and neuroleptic malignant syndrome. Extrapyramidal symptoms are caused by dopamine blockade or depletion in the basal ganglia; this lack of dopamine often mimics idiopathic pathologies of the extrapyramidal system. Less recognized is that extrapyramidal symptoms are also associated with certain non-antipsychotic agents, including some antidepressants, lithium, various anticonvulsants, antiemetics and, rarely, oral-contraceptive agents. Extrapyramidal symptoms caused by these agents are indistinguishable from neuroleptic-induced extrapyramidal symptoms. Clinicians must be able to recognize these side effects and be able to determine the antipsychotic-induced and non-antipsychotic causes of extrapyramidal symptoms.
抗精神病药物通常会产生锥体外系症状作为副作用。锥体外系症状包括急性运动障碍和张力障碍反应、迟发性运动障碍、帕金森症、运动不能、静坐不能以及抗精神病药恶性综合征。锥体外系症状是由基底神经节中的多巴胺阻断或耗竭引起的；这种多巴胺缺乏常常模仿锥体外系的特发性病变。较少被认识到的是，锥体外系症状也与某些非抗精神病药物有关，包括一些抗抑郁药、锂盐、各种抗惊厥药、止吐药，以及很少见的口服避孕药。这些药物引起的锥体外系症状与抗精神病药引起的锥体外系症状无法区分。临床医生必须能够识别这些副作用，并能够确定锥体外系症状的抗精神病药诱导原因和非抗精神病药原因。
