Kapsambelis V, Gekiere C, Ginestet D
Institut National Marcel Rivière, La Verrière.
Encephale. 1990 Mar-Apr;16(2):63-70.
Clinical classifications of neuroleptics constitute a particularity of European clinical psychopharmacology. However, the importance of evaluation scales in American psychiatry may also lead to an "implicit" clinical classification, since these drugs do not have the same effects upon the same patient. The main European classifications are described and some of actual clinic of neuroleptics are criticised, in particular the concepts of sedative, antipsychotic, antidelusional or antihallucinatory action. We have pointed out three clinical actions which should be selected in a present classification of neuroleptics; a) angolytic effect i.e. specific antianxiety action upon psychotic anxiety, often initiating the therapeutic processes; b) psychic reorganization effect that is the resultant, in schizophrenia, of the antiproductive and antideficitary effects; c) thymoleptic effect, i.e. reductive action upon the strength of passionate insistence and vindication in paranoïac disorders.
抗精神病药物的临床分类是欧洲临床精神药理学的一个特点。然而,评估量表在美国精神病学中的重要性也可能导致一种“隐性”临床分类,因为这些药物对同一患者的作用并不相同。本文描述了主要的欧洲分类,并对一些抗精神病药物的实际临床应用提出了批评,特别是镇静、抗精神病、抗妄想或抗幻觉作用的概念。我们指出了在目前抗精神病药物分类中应选择的三种临床作用:a)血管舒张作用,即对精神病性焦虑的特异性抗焦虑作用,通常启动治疗过程;b)精神重组作用,这是精神分裂症中抗幻觉和抗缺损作用的结果;c)心境稳定作用,即对偏执性障碍中强烈坚持和辩护的强度的降低作用。