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老年人药物性帕金森综合征和迟发性运动障碍的当前治疗与预防方法

Current Methods for the Treatment and Prevention of Drug-Induced Parkinsonism and Tardive Dyskinesia in the Elderly.

作者信息

Estevez-Fraga Carlos, Zeun Paul, López-Sendón Moreno Jose Luis

机构信息

Department of Neurodegenerative Diseases, UCL Institute of Neurology, London, UK.

Department of Neurology, Hospital Ramón y Cajal, Carretera de Colmenar Km 9.100 SN, 28034, Madrid, Spain.

出版信息

Drugs Aging. 2018 Nov;35(11):959-971. doi: 10.1007/s40266-018-0590-y.

Abstract

Drug-induced parkinsonism (DIP) and tardive dyskinesia (TD) are iatrogenic consequences of antidopaminergic drugs. Both are particularly prevalent among the elderly and those with dementia. However, despite their prevalence, these disorders are often overlooked. Both entities share risk factors, physiopathological mechanisms and, to some degree, therapeutic approaches. Withdrawing the causal agent, reducing the dose or switching to a less potent antidopaminergic drug should be the first therapeutic options. Here we review both entities and emerging therapies including the recently approved drugs deutetrabenazine and valbenazine. We discuss relevant aspects for clinical practice such as new diagnostic techniques and the latest advances in the understanding of DIP and TD.

摘要

药物性帕金森综合征(DIP)和迟发性运动障碍(TD)是抗多巴胺能药物引起的医源性后果。这两种疾病在老年人和痴呆患者中尤为常见。然而,尽管它们很普遍,但这些疾病常常被忽视。这两种疾病具有共同的危险因素、生理病理机制,并且在某种程度上具有共同的治疗方法。停用致病药物、减少剂量或换用效力较弱的抗多巴胺能药物应是首选的治疗方案。在此,我们综述这两种疾病以及新兴疗法,包括最近获批的药物氘代丁苯那嗪和丙戊苯那嗪。我们讨论了临床实践中的相关方面,如新的诊断技术以及对DIP和TD认识的最新进展。

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