Albayrak Yakup, Hashimoto Kenji
Department of Psychiatry, Kırklareli State Hospital, Kırklareli, Turkey (Dr Albayrak) and Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan (Dr Hashimoto).
Prim Care Companion CNS Disord. 2012;14(6). doi: 10.4088/PCC.12br01401. Epub 2012 Nov 8.
Tardive dyskinesia (TD) is characterized by involuntary, repetitive, purposeless movements that can affect different parts of the body. Tardive dyskinesia is a well-known side effect of conventional antipsychotics and commonly occurs after several years of treatment. The effective treatment of TD is unclear. Recently, the sigma-1 receptor agonist fluvoxamine was reported to be beneficial for hyperkinetic movement disorders.
We report 5 cases with postpsychotic depressive disorder of schizophrenia and TD. All patients were given fluvoxamine 100 mg/d, and after the second week the dosage of fluvoxamine was increased to 200 mg/d. At the fourth week, patients were assessed in terms of TD and postpsychotic depressive disorder of schizophrenia.
Fluvoxamine was found to be beneficial for TD and postpsychotic depressive disorder of schizophrenia in all patients by the fourth week.
Recently, the sigma-1 receptor agonist fluvoxamine has been considered beneficial for various neuropsychiatric disorders. However, data about the effects of fluvoxamine on hyperkinetic movement disorders are limited. In this report, we attempted to demonstrate the beneficial effects of fluvoxamine on TD, and we suggest that the mechanism of action might be due to sigma-1 agonism. Further detailed, double-blind studies should clarify the potential use of fluvoxamine in the treatment of hyperkinetic movement disorders.
迟发性运动障碍(TD)的特征是不自主、重复性、无目的的运动,可影响身体的不同部位。迟发性运动障碍是传统抗精神病药物众所周知的副作用,通常在治疗数年之后出现。TD的有效治疗方法尚不清楚。最近,有报道称σ-1受体激动剂氟伏沙明对运动亢进性运动障碍有益。
我们报告了5例精神分裂症后抑郁障碍合并TD的患者。所有患者均给予氟伏沙明100mg/d,第二周后氟伏沙明剂量增加至200mg/d。在第四周时,对患者的TD和精神分裂症后抑郁障碍进行评估。
到第四周时发现,氟伏沙明对所有患者的TD和精神分裂症后抑郁障碍均有益。
最近,σ-1受体激动剂氟伏沙明已被认为对各种神经精神疾病有益。然而,关于氟伏沙明对运动亢进性运动障碍影响的数据有限。在本报告中,我们试图证明氟伏沙明对TD的有益作用,并认为其作用机制可能是由于σ-1激动作用。进一步详细的双盲研究应阐明氟伏沙明在治疗运动亢进性运动障碍中的潜在用途。