Thomas Alissa A, Friedman Joseph H
Alpert Medical School, Brown University, Providence, RI 02886, USA.
Clin Neuropharmacol. 2010 Jan-Feb;33(1):14-6. doi: 10.1097/WNF.0b013e3181c47168.
Clozapine has been shown to be effective in the treatment of Parkinson disease psychosis and tremor; however, use of clozapine has been limited because of potential adverse effects and stringent monitoring criteria.
To evaluate safety and efficacy in a naturalistic setting, we conducted a retrospective chart review of all patients ever treated with clozapine at a movement disorders clinic in Rhode Island.
Clozapine was indicated for psychosis in 39 patients, for tremor in 19, and for both tremor and psychosis in an additional 6 patients. Fifty of 61 patients reported improvement in their symptoms. Clozapine use was interrupted in 26 patients, for various reasons including transition to hospice care (3), worsening of motor symptoms (4), agranulocytosis (1), intolerable adverse effects (9), symptom resolution (2), and other or unknown reasons (7).
Clozapine may be useful in the management of movement disorders and related symptoms so long as adequate supervision and monitoring can be provided.
氯氮平已被证明对帕金森病精神病和震颤有效；然而，由于潜在的不良反应和严格的监测标准，氯氮平的使用受到限制。
为了评估在自然环境中的安全性和有效性，我们对罗德岛一家运动障碍诊所所有接受过氯氮平治疗的患者进行了回顾性病历审查。
39例患者使用氯氮平治疗精神病，19例用于震颤，另有6例用于震颤和精神病。61例患者中有50例报告症状改善。26例患者因各种原因中断使用氯氮平，包括转至临终关怀护理（3例）、运动症状恶化（4例）、粒细胞缺乏症（1例）、无法耐受的不良反应（9例）、症状缓解（2例）以及其他或不明原因（7例）。
只要能提供充分的监督和监测，氯氮平可能对运动障碍及相关症状的管理有用。
