Menkes D B, Clarkson H O, Caradoc-Davies G, Mullen P E
Department of Psychological Medicine, University of Otago, Dunedin, New Zealand.
Int Clin Psychopharmacol. 1987 Jan;2(1):55-67. doi: 10.1097/00004850-198701000-00005.
The tendency of antipsychotics to produce extrapyramidal side-effects varies inversely with their antimuscarinic activity. This paper reviews the antipsychotic and antimuscarinic potency of these drugs and compares the total antimuscarinic activity in standard daily doses of antipsychotics, antiparkinson agents and antidepressants. The authors examine factors associated with tolerance of benztropine withdrawal in 39 inpatients. Patients with serious EPS relapse after benztropine withdrawal had an excess of antipsychotic over antimuscarinic activity in their remaining medications. The results suggest an optimal ratio between total antipsychotic and anticholinergic doses, and a simple model for predicting antiparkinson drug requirements.
抗精神病药物产生锥体外系副作用的倾向与其抗毒蕈碱活性成反比。本文综述了这些药物的抗精神病和抗毒蕈碱效力，并比较了抗精神病药、抗帕金森病药和抗抑郁药标准日剂量中的总抗毒蕈碱活性。作者研究了39例住院患者中与苯海索撤药耐受性相关的因素。苯海索撤药后出现严重锥体外系反应复发的患者，其剩余药物中的抗精神病活性超过抗毒蕈碱活性。结果提示了总抗精神病剂量与抗胆碱能剂量之间的最佳比例，以及一个预测抗帕金森病药物需求的简单模型。
