Lavin M R, Rifkin A
Department of Psychiatry, Hillside Hospital, New Hyde Park, New York.
J Clin Pharmacol. 1991 Aug;31(8):763-8. doi: 10.1002/j.1552-4604.1991.tb03774.x.
The use of prophylactic antiparkinson medications during neuroleptic treatment is controversial. Although the efficacy of these agents in the treatment of extrapyramidal side effects is well established, the questions of when to initiate therapy and for how long remain unanswered. There are only a few double-blind, placebo-controlled studies on the value of concurrent antiparkinson drug use at the beginning of neuroleptic treatment. The authors reviewed all studies on initial prophylaxis, and found most to be methodologically deficient. There is evidence to support the use of these agents to prevent acute dystonic reactions. Further work needs to focus on other types of extrapyramidal symptoms. In light of the inability to predict who will experience these side effects, the authors conclude that initial prophylaxis is beneficial for most patients who are starting neuroleptic medications.
在使用抗精神病药物治疗期间预防性使用抗帕金森药物存在争议。尽管这些药物在治疗锥体外系副作用方面的疗效已得到充分证实，但何时开始治疗以及治疗多长时间的问题仍未得到解答。关于在抗精神病药物治疗开始时同时使用抗帕金森药物的价值，仅有少数双盲、安慰剂对照研究。作者回顾了所有关于初始预防的研究，发现大多数在方法上存在缺陷。有证据支持使用这些药物预防急性肌张力障碍反应。进一步的研究需要关注其他类型的锥体外系症状。鉴于无法预测谁会出现这些副作用，作者得出结论，初始预防对大多数开始使用抗精神病药物的患者有益。
