Yang S-Y, Kao Yang Y-H, Chong M-Y, Yang Y-H, Chang W-H, Lai C-S
Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Clin Pharmacol Ther. 2007 Apr;81(4):586-94. doi: 10.1038/sj.clpt.6100069. Epub 2007 Jan 18.
To compare the prevalence of extrapyramidal syndrome (EPS) between the first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs), the co-prescribing rate of anti-Parkinson drugs (APDs) of each antipsychotic drug was analyzed using population database. Fourteen antipsychotics had been prescribed during the 5-year study period. Among the SGAs, quetiapine had the lowest crude co-prescribing rate of APDs (27.09%), whereas risperidone had the highest rate (66.50%). Among the FGAs, thioridazine and loxapine had the lowest (60.99%) and highest rates (96.35%), respectively. The rankings of the co-prescribing rate of APDs among antipsychotics, in increasing order, were quetiapine, clozapine, olanzapine, thioridazine, zotepine, chlorpromazine, risperidone, sulpiride, clotiapine, flupentixol, haloperidol, zuclopentixol, trifluoperazine, and loxapine. The results indicate that the risk of EPS appears to be lower in SGAs than in FGAs; however, the considerably high rate of EPS in some of the newer generation of antipsychotics warrants clinical attention.
为比较第一代抗精神病药物(FGA)和第二代抗精神病药物(SGA)锥体外系综合征(EPS)的患病率,利用人群数据库分析了每种抗精神病药物的抗帕金森病药物(APD)联合处方率。在5年研究期间共开出了14种抗精神病药物。在SGA中,喹硫平的APD粗联合处方率最低(27.09%),而利培酮的联合处方率最高(66.50%)。在FGA中,硫利达嗪和洛沙平的联合处方率分别最低(60.99%)和最高(96.35%)。抗精神病药物中APD联合处方率的排名由低到高依次为喹硫平、氯氮平、奥氮平、硫利达嗪、佐替平、氯丙嗪、利培酮、舒必利、氯噻平、氟哌噻吨、氟哌啶醇、珠氯噻醇、三氟拉嗪和洛沙平。结果表明,SGA中EPS的风险似乎低于FGA;然而,一些新一代抗精神病药物中EPS的发生率相当高,值得临床关注。