Markkula Juha, Helenius Hans, Lauerma Hannu
Department of Psychiatry, University of Turku, Kunnallissairaalantie 20 rak 9, Turku, Finland.
Nord J Psychiatry. 2007;61(2):152-7. doi: 10.1080/08039480701226146.
Metabolic side-effects of atypical antipsychotics have led to concern about their relative safety compared with low doses of conventional neuroleptics. Akathisia is an often misdiagnosed side-effect, which leads to non-compliance and sometimes even exacerbation of psychosis or suicidal behaviour. In fact, little is known about the differences between antipsychotic drugs in clinical practice, since only as few as 20% of patients may be eligible for studies comparing antipsychotic medications with each other. The aim of this study was to find out if the use of conventional antipsychotics is associated with an increased risk of akathisia (compared with atypical antipsychotics) even when low doses of conventional antipsychotics are used. The Barnes Akathisia Rating Scale was used to evaluate akathisia in 100 outpatients on antipsychotic medication. Conventional antipsychotics were associated with an increased risk of akathisia compared with atypical antipsychotics, although the chlorpromazine equivalent doses of conventional antipsychotics were lower than those of the atypicals. An additional akathisia-provoking effect of SSRIs could not be ruled out. The results suggest favouring atypical antipsychotic medication in patients who may easily develop akathisia.
非典型抗精神病药物的代谢副作用引发了人们对其与低剂量传统抗精神病药物相比相对安全性的担忧。静坐不能是一种常被误诊的副作用，它会导致患者不依从治疗，有时甚至会加重精神病症状或引发自杀行为。事实上，对于临床实践中抗精神病药物之间的差异了解甚少，因为只有20%的患者可能符合相互比较抗精神病药物的研究条件。本研究的目的是确定即使使用低剂量的传统抗精神病药物，其使用是否与静坐不能风险增加相关（与非典型抗精神病药物相比）。使用巴恩斯静坐不能评定量表对100名服用抗精神病药物的门诊患者的静坐不能情况进行评估。与非典型抗精神病药物相比，传统抗精神病药物与静坐不能风险增加相关，尽管传统抗精神病药物的氯丙嗪等效剂量低于非典型抗精神病药物。不能排除选择性5-羟色胺再摄取抑制剂（SSRI）额外的引发静坐不能的作用。结果表明，对于可能容易出现静坐不能的患者，非典型抗精神病药物治疗更具优势。
