新型抗精神病药物致药物诱导运动障碍的风险。
Risk of Drug-induced Movement Disorders with Newer Antipsychotic Agents.
机构信息
Philadelphia Parkinson's Disease Research, Education and Clinical Center, Corporal Michael J. Crescenz Department of Veterans Affairs Medical Center, Philadelphia, PA, USA.
Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
出版信息
Tremor Other Hyperkinet Mov (N Y). 2022 Jun 8;12:19. doi: 10.5334/tohm.695. eCollection 2022.
BACKGROUND
The last decade has seen development of numerous novel antipsychotic drugs with unique mechanisms including long-acting formulations for clinical use. A comparative assessment of these new drugs with each other and previous antipsychotics have not been performed with regards to risk for drug-induced movement disorders (DIMD).
METHODS
Medline was searched from January 2010 to February 2022 for primary research articles and review articles in English using the search terms "extrapyramidal" and "tardive" with individual drug names of novel antipsychotics.
RESULTS
We identified articles describing the risk of DIMD with 6 novel antipsychotics, 4 novel formulations, and 3 experimental antipsychotics. Both short- and long-term data generally showed comparable to lower risk of DIMD with novel antipsychotics and recent long-acting formulations compared to previously marketed antipsychotics.
DISCUSSION
Several novel antipsychotics, particularly lumateperone and pimavanserin, show promise in being able to treat psychosis while reducing the risk of DIMD. Long-acting paliperidone may reduce risk of DIMD while other long-acting injectable formulations of SGA have similar risk of DIMD compared to oral formulations. New drug targets for treating psychosis without dopamine blockade also show promise.
背景
在过去的十年中，出现了许多具有独特作用机制的新型抗精神病药物，包括用于临床的长效制剂。尚未对这些新药与其他抗精神病药物进行相互比较评估，以评估其引起药物诱导运动障碍（DIMD）的风险。
方法
使用搜索词“锥体外系”和“迟发性”以及新型抗精神病药物的个别药物名称，从 2010 年 1 月至 2022 年 2 月在 Medline 上以英文搜索了原始研究文章和综述文章。
结果
我们确定了描述 6 种新型抗精神病药物、4 种新型制剂和 3 种实验性抗精神病药物的 DIMD 风险的文章。短期和长期数据通常表明，新型抗精神病药物和最近的长效制剂与以前上市的抗精神病药物相比，DIMD 的风险相似或更低。
讨论
几种新型抗精神病药物，特别是鲁拉西酮和匹莫范色林，在治疗精神病的同时降低 DIMD 的风险方面显示出了希望。长效帕利哌酮可能会降低 DIMD 的风险，而其他长效 SGAs 注射制剂与口服制剂相比，DIMD 的风险相似。治疗精神病而不阻断多巴胺的新药物靶点也显示出了希望。
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