Danielczyk W
Wien Med Wochenschr Suppl. 1979;55:1-15.
269 patients suffering from progredient, chronic either primary or secundary cerebral diseases (Parkinson's disease, cerebral vascular diseases, cerebral atrophic dystrophy, Huntington's chorea, muliple sclerosis have been studied in the last two years. 44 of these patients developed pharmaco-toxic psychoses during drug treatment (low and medium dosis). The psycho-pathological rating resulted in an acute organic brain syndrome with predominance of confusion, sometimes progressing to delirium. EEG was changed during the psychotic stage. These changes cannot be decided from organic psychoses, which are not related to drugs. Patients with Parkinson's disease showed a relatively high incidence to psychoses during drug treatment (51.47%). In patients without Parkinson's disease, but on treatment with antidepressants, neuroleptics, diuretics and digitalis, pharmacotoxic psychoses only could be observed in 4.4% of the patients. However, the same group of patients showed an acute organic brain syndrome in 12.43%, when not on treatment. Combined treatment with L-DOPA plus peripherally acting decarboxylase inhibitors resulted in a high incidence to psychoses in idiopathic Parkinsonism but the same dosis produced this side effect only in a few patients with cerebral atrophic dystrophy. The ratio was 5:1 between the former group and the later one. That means, that L-DOPA is a much more psychotoxic substance in Parkinsonism when compared to other cerebral diseases. These pharmacotoxic psychoses could be correlated with the progredience of the disease. These pharmacotoxic psychoses are not only dependent from age and duration of treatment. Evidence exist, that there might be a correlation between the incidence for pharmacotoxic psychoses and the lack of surviving dopaminergic neurons in the nigro-striatal areas. Treatment with very low doses of neuroleptics suppresses pharmacotoxic psychoses but allow a further anti-Parkinson therapy which is of vital necessity.
在过去两年中，对269例患有进行性慢性原发性或继发性脑部疾病（帕金森病、脑血管疾病、脑萎缩性营养不良、亨廷顿舞蹈病、多发性硬化症）的患者进行了研究。其中44例患者在药物治疗（低剂量和中等剂量）期间出现了药物中毒性精神病。心理病理学评定结果为急性器质性脑综合征，以意识模糊为主，有时会发展为谵妄。在精神病阶段脑电图发生了变化。这些变化与非药物性的器质性精神病无法区分。帕金森病患者在药物治疗期间出现精神病的发生率相对较高（51.47%）。在没有帕金森病但使用抗抑郁药、抗精神病药、利尿剂和洋地黄进行治疗的患者中，仅4.4%的患者出现了药物中毒性精神病。然而，同一组患者在未接受治疗时，急性器质性脑综合征的发生率为12.43%。左旋多巴加外周作用脱羧酶抑制剂的联合治疗在特发性帕金森病中导致精神病的发生率较高，但相同剂量仅在少数脑萎缩性营养不良患者中产生这种副作用。前一组与后一组的比例为5:1。这意味着，与其他脑部疾病相比，左旋多巴在帕金森病中是一种更具精神毒性的物质。这些药物中毒性精神病可能与疾病的进展相关。这些药物中毒性精神病不仅取决于年龄和治疗持续时间。有证据表明，药物中毒性精神病的发生率与黑质纹状体区域存活的多巴胺能神经元缺乏之间可能存在关联。用极低剂量的抗精神病药进行治疗可抑制药物中毒性精神病，但允许进行至关重要的进一步抗帕金森治疗。
