De Hert Marc, Wampers Martien, van Winkel Ruud, Peuskens Jozef
University Psychiatric Centre Katholieke Universiteit Leuven, Campus Kortenberg, Leuvensesteenweg 517, 3070 Kortenberg, Belgium.
Psychiatry Res. 2007 Aug 30;152(2-3):165-72. doi: 10.1016/j.psychres.2006.07.012. Epub 2007 Apr 18.
This naturalistic study aims to evaluate the influence of antipsychotic treatment on the use of anticholinergics. The observed use of anticholinergics will give an indication of the occurrence of extrapyramidal side effects (EPS) in the different antipsychotic treatment conditions. The medication use of 1215 hospitalised patients with DSM-IV 295.xx diagnosis is recorded. Four antipsychotic treatment conditions are distinguished: 1) only first generation antipsychotics (FGA): patients receive one or a combination of first generation antipsychotics, 2) a combination of high potency FGA and second generation antipsychotics (SGA), 3) a combination of low potency FGA and SGA, and 4) only SGA: patients receive one or a combination of SGA. Antipsychotic treatment significantly influences the use of anticholinergics. Anticholinergic use is highest in patients treated with high potency FGA (whether or not in combination with SGA) as compared with patients only treated with SGA and patients combining SGA with low potency FGA. The two latter groups do not significantly differ. However, there were no significant differences in the prevalence of EPS with the exception of akathisia between FGA and SGA. Thus, through the use of anticholinergics, EPS induced by FGA can be effectively reduced.
这项自然主义研究旨在评估抗精神病药物治疗对抗胆碱能药物使用的影响。观察到的抗胆碱能药物使用情况将表明在不同抗精神病药物治疗条件下锥体外系副作用（EPS）的发生情况。记录了1215名诊断为DSM-IV 295.xx的住院患者的用药情况。区分了四种抗精神病药物治疗条件：1）仅使用第一代抗精神病药物（FGA）：患者接受一种或多种第一代抗精神病药物；2）高效能FGA与第二代抗精神病药物（SGA）联合使用；3）低效能FGA与SGA联合使用；4）仅使用SGA：患者接受一种或多种SGA。抗精神病药物治疗显著影响抗胆碱能药物的使用。与仅接受SGA治疗的患者以及将SGA与低效能FGA联合使用的患者相比，接受高效能FGA治疗的患者（无论是否与SGA联合使用）抗胆碱能药物的使用量最高。后两组之间没有显著差异。然而，除静坐不能外，FGA和SGA在EPS患病率方面没有显著差异。因此，通过使用抗胆碱能药物，可以有效减少FGA引起的EPS。
