Wright Padraig, O'Flaherty Luke
St. Brendan's Hospital,PO Box 418,Rathdown Road,Dublin 7,Ireland and Senior Lecturer (Honorary),Institute of Psychiatry,London,England.
St Brendan's Hospital,Rathdown Road,Dublin 7,Ireland.
Ir J Psychol Med. 2003 Mar;20(1):24-27. doi: 10.1017/S0790966700007497.
Atypical antipsychotic drugs are recommended for the first line treatment of all patients with schizophrenia. This is because it has been demonstrated that atypical antipsychotic drugs are more effective across a broader range of symptoms of schizophrenia than typical antipsychotic drugs and because they are dramatically less likely to cause the extrapyramidal and endocrine side effects that greatly impair quality of life for patients and reduce their willingness to adhere to maintenance treatment. Atypical antipsychotic drugs are not perfect but they are the most effective and the safest treatment for schizophrenia presently available. The atypical antipsychotic drugs currently marketed in Ireland for the first line treatment of schizophrenia include amisulpride, olanzapine, quetiapine, risperidone and ziprasidone. These agents differ somewhat in chemical class, indications, daily dose range, need for titration, daily dosing regimen and available formulations (see Table 1). Clozapine is marketed for patients unresponsive to, or intolerant of, other antipsychotic drugs and must thus be regarded as a second line treatment for schizophrenia. Zotepine is not yet available in Ireland while the marketing of sertindole has been suspended following reports of arrhythmias and sudden cardiac deaths.
非典型抗精神病药物被推荐用于所有精神分裂症患者的一线治疗。这是因为已证明非典型抗精神病药物在治疗精神分裂症的更广泛症状方面比典型抗精神病药物更有效，而且它们引发锥体外系和内分泌副作用的可能性大大降低，这些副作用会严重损害患者的生活质量并降低他们坚持维持治疗的意愿。非典型抗精神病药物并非完美无缺，但它们是目前可用于治疗精神分裂症的最有效和最安全的药物。目前在爱尔兰用于精神分裂症一线治疗的非典型抗精神病药物包括氨磺必利、奥氮平、喹硫平、利培酮和齐拉西酮。这些药物在化学类别、适应症、每日剂量范围、滴定需求、每日给药方案和可用剂型方面有所不同（见表1）。氯氮平用于对其他抗精神病药物无反应或不耐受的患者，因此必须被视为精神分裂症的二线治疗药物。佐替平在爱尔兰尚未上市，而在有报道称出现心律失常和心源性猝死之后，舍吲哚已暂停销售。
