Fernandez Hubert H, Friedman Joseph H, Lansang M Cecilia, Factor Stewart A, Molho Eric S, Coskun D Jim
Department of Neurology, University of Florida, Gainesville, FL, USA.
Parkinsonism Relat Disord. 2004 Oct;10(7):439-41. doi: 10.1016/j.parkreldis.2004.04.007.
Clozapine is the gold standard treatment for Parkinson's disease (PD) psychosis based on double blinded, placebo controlled trials, and has also been shown to alleviate tremor and dyskinesia. There is accumulating data suggesting that clozapine may be associated with increased frequency of diabetes mellitus (DM) compared to conventional neuroleptic drugs in treating schizophrenia. Forty-four predominantly geriatric parkinsonian subjects on clozapine for psychosis, tremor or dyskinesia, on an average dose of 50.6 mg/d for a mean duration of 41 months were reviewed. The prevalence of DM in this cohort was 18.1% (8/44). This rate was similar to that reported in the aged-matched general population (prevalence = 19.3% for ages > or = 60 years). In this small study, parkinsonian patients on long-term, low dose clozapine were not at increased risk for developing DM. Larger controlled prospective studies are needed to confirm this.
基于双盲、安慰剂对照试验，氯氮平是治疗帕金森病（PD）精神病的金标准疗法，并且还已显示可减轻震颤和运动障碍。有越来越多的数据表明，与传统抗精神病药物治疗精神分裂症相比，氯氮平可能与糖尿病（DM）发病率增加有关。对44名主要为老年帕金森病患者进行了回顾，这些患者因精神病、震颤或运动障碍服用氯氮平，平均剂量为50.6毫克/天，平均疗程为41个月。该队列中DM的患病率为18.1%（8/44）。这一比率与年龄匹配的普通人群中报告的比率相似（年龄≥60岁者患病率=19.3%）。在这项小型研究中，长期服用低剂量氯氮平的帕金森病患者发生DM的风险并未增加。需要更大规模的对照前瞻性研究来证实这一点。
