Debrey Sarah M, Goldsmith David R
Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta.
Focus (Am Psychiatr Publ). 2021 Jan;19(1):14-23. doi: 10.1176/appi.focus.20200038. Epub 2021 Jan 25.
Tardive dyskinesia (TD) is a debilitating, iatrogenic, and potentially severe movement disorder characterized by involuntary, repetitive, purposeless movements that are present throughout the body. The authors present a review of studies of past, current, and possible future treatment approaches to the management of TD; consider the phenomenology, assessment, and putative pathophysiological mechanisms of TD, early pharmacological trials, a focus on the newer vesicular monoamine transporter 2 inhibitors, and other evidence-based approaches, such as clozapine; and present preliminary evidence for newer approaches, such as deep brain stimulation and repetitive transcranial magnetic stimulation. On the basis of the evidence presented here, the authors highlight the importance of early recognition and assessment of TD, as well as how to best approach management of these often incapacitating symptoms.
迟发性运动障碍(TD)是一种使人衰弱的医源性疾病,可能会发展为严重的运动障碍,其特征为全身出现不自主、重复性、无目的的运动。作者对过去、当前以及未来可能用于治疗TD的方法进行了综述;探讨了TD的症状表现、评估方法及假定的病理生理机制、早期药物试验、对新型囊泡单胺转运体2抑制剂的关注以及其他循证方法,如氯氮平;并介绍了一些新方法(如深部脑刺激和重复经颅磁刺激)的初步证据。基于本文所提供的证据,作者强调了早期识别和评估TD的重要性,以及如何最好地处理这些常常使人丧失能力的症状。