Wolf M A, Villeneuve A
Département de Psychiatrie, Faculté de Médecine, Université Laval, Sainte-Foy, Québec, Canada.
Encephale. 1990 Mar-Apr;16(2):111-24.
Due to their pharmacological activity on various receptors, particularly dopaminergic, cholinergic and adrenergic ones, neuroleptics induce various side effects, central as well as peripheric. These side effects are of various nature: psychic and cognitive, neurologic affecting mostly the extrapyramidal system, neuroendocrinian and metabolic, as well as neurovegetative. Toxic manifestations, hepatic, hematologic and others, have been associated with their use, as well as a malignant syndrome that can be lethal. They also have a potential teratogenic action. Their main side effects are therefore described and discussed as to their physiopathology and treatment. Nevertheless, in spite of their various side effects, neuroleptics represent a valuable and effective tool in the treatment of various psychotic disorders, namely schizophrenia. Their main pharmacological property is their ability to induce extrapyramidal side effects. In this respect, the prophylactic administration of an antiparkinsonian agent remains a controversial issue. Finally, the occurrence of tardive dyskinesia has given rise to civil litigation and ethical considerations should be borne in mind in their use.
由于抗精神病药物对各种受体,特别是多巴胺能、胆碱能和肾上腺素能受体具有药理活性,它们会引发各种中枢和外周的副作用。这些副作用具有多种性质:精神和认知方面的、主要影响锥体外系的神经方面的、神经内分泌和代谢方面的以及神经植物性方面的。与它们的使用相关的还有毒性表现,如肝脏、血液等方面的,以及一种可能致命的恶性综合征。它们还具有潜在的致畸作用。因此,将对它们的主要副作用在生理病理学及治疗方面进行描述和讨论。然而,尽管有各种副作用,抗精神病药物仍是治疗各种精神障碍,即精神分裂症的一种有价值且有效的工具。它们的主要药理特性是能够引发锥体外系副作用。在这方面,预防性给予抗帕金森病药物仍是一个有争议的问题。最后,迟发性运动障碍的发生引发了民事诉讼,在使用这些药物时应牢记伦理方面的考量。