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抗精神病药引起的迟发性运动障碍:流行病学和治疗的最新进展。

Antipsychotic-induced tardive dyskinesia: update on epidemiology and management.

机构信息

Department of Psychiatry, Psychotherapy, and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria.

出版信息

Curr Opin Psychiatry. 2019 May;32(3):179-184. doi: 10.1097/YCO.0000000000000491.

Abstract

PURPOSE OF REVIEW

To provide an update on the frequency of antipsychotic-induced tardive dyskinesia and its management in patients with schizophrenia spectrum disorders in studies published since the last systematic review in 2008.

RECENT FINDINGS

Recent data about antipsychotic-induced tardive dyskinesia in patients with schizophrenia underscore the superiority of newer generation antipsychotics (21%) over first-generation antipsychotics (30%) with respect to prevalence and incidence rates. Regarding recently tested management strategies, the new vesicular monoamine transporter 2 inhibitors valbenazine and deutetrabenazine have been found to be effective and may be considered as first-line pharmacotherapy for tardive dyskinesia. Owing to quality issues of randomized controlled trials and/or small sample sizes, limited and conflicting evidence remains for most treatment strategies.

SUMMARY

The reviewed literature reveals lower prevalence rates of antipsychotic-induced tardive dyskinesia in patients treated with newer generation compared with first-generation antipsychotics. The evidence of vesicular monoamine transporter 2 inhibitors as a first-line therapy for tardive dyskinesia is well supported by several controlled clinical trials.

摘要

目的综述

提供自 2008 年上一次系统综述以来,有关精神分裂症谱系障碍患者中抗精神病药引起迟发性运动障碍的频率及其治疗的最新研究进展。

最新发现

有关精神分裂症患者抗精神病药引起迟发性运动障碍的最新数据强调,与第一代抗精神病药(30%)相比,新一代抗精神病药(21%)在患病率和发病率方面具有优势。关于最近测试的治疗策略,新的囊泡单胺转运体 2 抑制剂瓦伦扎嗪和右苯丙胺已被证明是有效的,可被视为迟发性运动障碍的一线药物治疗。由于随机对照试验的质量问题和/或样本量小,大多数治疗策略的证据仍然有限且存在冲突。

总结

综述文献显示,与第一代抗精神病药相比,接受新一代抗精神病药治疗的患者中抗精神病药引起的迟发性运动障碍的患病率较低。几项对照临床试验有力支持囊泡单胺转运体 2 抑制剂作为迟发性运动障碍的一线治疗药物。

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