Thomson Sereen Rose, Chogtu Bharti, Bhattacharjee Dipanjan, Agarwal Saurabh
Department of Pharmacology, Kasturba Medical College, Manipal Campus, Manipal University, Manipal, India.
Ann Neurosci. 2017 Jul;24(3):155-163. doi: 10.1159/000477153. Epub 2017 Jul 24.
Atypical antipsychotics, like risperidone purportedly, score over their typical counterparts in terms of their lower propensity toward producing extrapyramidal symptoms (EPS). However, recent studies have furnished evidence to the contrary. Hereby, we present a case series implicating risperidone as the causative agent for EPS.
As a part of the pharmacovigilance programme of India, the authors have assessed 10 physician-reported cases of EPS among the 1,830 patients who were prescribed risperidone within the time period of January 2012-December 2014 in a tertiary care hospital in South India. Causality, severity, and preventability assessments of adverse reaction were done as per Naranjo's, Hartwig's, and Thornton'scale respectively.
Of the 10 cases, a dose-dependent occurrence of EPS was noted in all and the time duration for development of EPS ranged from 1 week to 2 years. Four patients developed EPS at a dose of 6-8 mg, 4 developed at a dose of 4-6 mg, and the remaining 2 developed at 2 and 1 mg.
A strong temporal correlation between risperidone and EPS was noted in all cases. High doses produced EPS early, whereas moderate to low doses produced EPS at a later date. Thus, cautious use and close monitoring are warranted in the chronic use of risperidone.
非典型抗精神病药物，如据称的利培酮，在产生锥体外系症状（EPS）的倾向较低方面优于其典型同类药物。然而，最近的研究提供了相反的证据。在此，我们呈现一系列病例，表明利培酮是EPS的致病因素。
作为印度药物警戒计划的一部分，作者评估了2012年1月至2014年12月期间在印度南部一家三级护理医院接受利培酮治疗的1830例患者中，医生报告的10例EPS病例。分别根据纳兰霍、哈特维希和桑顿量表对不良反应进行因果关系、严重程度和可预防性评估。
在这10例病例中，均观察到EPS呈剂量依赖性发生，EPS出现的时间持续范围为1周至2年。4例患者在6 - 8毫克剂量时出现EPS，4例在4 - 6毫克剂量时出现，其余2例在2毫克和1毫克剂量时出现。
在所有病例中均注意到利培酮与EPS之间存在强烈的时间相关性。高剂量早期产生EPS，而中低剂量则在较晚时间产生EPS。因此，在长期使用利培酮时需要谨慎使用并密切监测。
