Morton and Gloria Shulman Movement Disorders Center and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada.
Parkinsonism Relat Disord. 2014 Jan;20 Suppl 1:S113-7. doi: 10.1016/S1353-8020(13)70028-2.
Tardive syndromes (TS) encompass a broad spectrum of abnormal movements due to chronic exposure to dopamine receptor blocking agents. This review provides a compiled update on TS, including phenomenology, epidemiology, pathophysiology, genetic correlations and therapeutics, highlighting the emerging experience with atypical antipsychotics. The advent of atypical antipsychotics, which have lower affinity for dopamine receptors and act on 5-HT2A and 5-HT2C serotonin receptors, was expected to dramatically reduce the prevalence and incidence of this iatrogenic problem. Recent studies have shown that the reduction has been more modest than expected and TS remains an important challenge. Recent insights on pathophysiology, risk factors and genetic correlations have raised the hope for further individualized treatment for schizophrenic patients, and more strict use of antipsychotics. Up to now, there is no definite treatment for TS, but options range from relatively innocuous low doses of propranolol to more invasive procedures such as deep brain stimulation.
迟发性运动障碍（TS）是由于长期暴露于多巴胺受体阻滞剂而引起的广泛异常运动。本综述提供了关于 TS 的最新综合信息，包括其现象学、流行病学、发病机制、遗传相关性和治疗方法，重点介绍了新型抗精神病药物的应用经验。新型抗精神病药物对多巴胺受体的亲和力较低，对 5-HT2A 和 5-HT2C 血清素受体有作用，预计会显著降低这种医源性问题的发生率和患病率。但最近的研究表明，这种减少比预期的要小，TS 仍然是一个重要的挑战。最近对发病机制、危险因素和遗传相关性的深入了解，为进一步个体化治疗精神分裂症患者和更严格使用抗精神病药物带来了希望。到目前为止，还没有针对 TS 的明确治疗方法，但治疗方案从相对无害的低剂量普萘洛尔到深部脑刺激等更具侵入性的治疗方法都有。
