Witter Daniel P, Holbert Richard C, Suryadevara Uma
a Department of Psychiatry , University of Florida College of Medicine , Gainesville , FL , USA.
b University of Florida Psychiatric Hospital , Gainesville , FL , USA.
Expert Opin Pharmacother. 2017 Jul;18(10):965-972. doi: 10.1080/14656566.2017.1323874. Epub 2017 May 8.
Tardive dyskinesia (TD) is an iatrogenic movement disorder most commonly observed in patients with psychotic disorders who are treated with dopamine blocking antipsychotic medications. Treatment options are limited, and recommendations for treatment are based on a relative scarcity of evidence. Areas covered: After briefly highlighting current mechanistic theories of TD, this review will discuss the evidence for a number of medications of several different classes that have been studied for the treatment of TD since the 1970s with an emphasis on placebo controlled trials when possible. We used a Pubmed search of primary studies, reviews, and metaanalyses on the topic of TD treatment in order to cover this topic. Expert opinion: Treatment of TD is difficult given limited data and incomplete understanding of the mechanism. Treatment of TD must be evaluated on an individual basis with careful weight given to severity of symptoms. We suggest the use of atypical versus conventional antipsychotics whenever possible and would recommend trials with one or more of a number of additional agents starting with valbenazine.
迟发性运动障碍（TD）是一种医源性运动障碍，最常见于接受多巴胺阻断性抗精神病药物治疗的精神障碍患者。治疗选择有限，治疗建议基于相对较少的证据。涵盖领域：在简要强调TD当前的机制理论后，本综述将讨论自20世纪70年代以来研究用于治疗TD的几种不同类别药物的证据，尽可能侧重于安慰剂对照试验。我们使用PubMed搜索了关于TD治疗主题的原始研究、综述和荟萃分析以涵盖该主题。专家意见：鉴于数据有限且对机制理解不完整，TD的治疗很困难。TD的治疗必须根据个体情况进行评估，并仔细权衡症状的严重程度。我们建议尽可能使用非典型抗精神病药物而非传统抗精神病药物，并建议从缬苯那嗪开始试用一种或多种其他药物。
