Tebeka S, Airagnes G, Limosin F
Faculté de médecine, université Paris 7 Denis Diderot, 75018 Paris, France; Service de psychiatrie, hôpital Louis-Mourier, AP-HP, 92700 Colombes, France.
Faculté de médecine, université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Pôle psychiatrie et addictions, hôpitaux universitaires Paris Ouest, AP-HP, 75015 Paris, France; Inserm, Population-based Epidemiologic Cohorts Unit, UMS 011, 94800 Villejuif, France.
Rev Med Interne. 2017 May;38(5):328-336. doi: 10.1016/j.revmed.2016.12.007. Epub 2017 Feb 10.
Antipsychotics are commonly prescribed in the general population since they have many indications. They can be used in acute care such as agitation or behavior disorders, or to treat more characterized psychiatric disorders like psychotic or mood disorders. Consequently, any practitioner will have to prescribe or renew a prescription of antipsychotics. These treatments require a benefit/risk balance assessment taking into account the specific context of each patient. Indeed, antipsychotics have many side effects, mainly neurological (extrapyramidal syndrome, dyskinesia, akathisia), metabolic and cardiac. If these complications are poorly controlled, they could dramatically increase the morbidity and the mortality. Second-generation antipsychotics should be preferred to first-generation antipsychotics because of their better safety profile, especially in case of prolonged prescribing. Treatment monitoring, including effectiveness on the targeted symptoms, tolerance and observance, are major issues in the management of patients treated with antipsychotics.
抗精神病药物在普通人群中普遍使用,因为它们有多种适应症。它们可用于急性护理,如躁动或行为障碍,或用于治疗更具特征性的精神疾病,如精神病性或情绪障碍。因此,任何从业者都必须开具或续签抗精神病药物的处方。这些治疗需要进行获益/风险平衡评估,同时考虑到每个患者的具体情况。事实上,抗精神病药物有许多副作用,主要是神经方面的(锥体外系综合征、运动障碍、静坐不能)、代谢方面的和心脏方面的。如果这些并发症控制不佳,可能会显著增加发病率和死亡率。由于第二代抗精神病药物具有更好的安全性,尤其是在长期用药的情况下,应优先选用第二代抗精神病药物而非第一代抗精神病药物。治疗监测,包括对目标症状的有效性、耐受性和依从性,是抗精神病药物治疗患者管理中的主要问题。