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寻找迟发性运动障碍的治疗方法:文献综述

In search of treatment for tardive dyskinesia: review of the literature.

作者信息

Jeste D V, Wyatt R J

出版信息

Schizophr Bull. 1979;5(2):251-93. doi: 10.1093/schbul/5.2.251.

Abstract

Studies on the treatments for neuroleptic-induced tardive dyskinesia published in the English literature until August 1978 are reviewed. There is a yet no single satisfactory method of treatment for tardive dyskinesia. Withdrawal of neuroleptics results in a remission of symptoms in younger and non-brain-damaged patients. Paradoxically, the most effective treatment for suppressing dyskinesia is administration of neuroleptics. The possibility that continued use of neuroleptics in dyskinesia patients produces irreversible brain damage remains to be validated (or invalidated). Anticholinergic and dopaminergic drugs are of no value in the treatment of tardive dyskinesia. Cholinergic drugs have not lived up to their initial promising results in this condition. About one third of the dyskinetic subjects seem to respond to various nonspecific measures. Tardive dyskinesia probably consists of at least two subtypes-- reversible and persistent. Methodological aspects of earlier studies and possibilities for future research in this field are discussed. Suggestions for treatment of individual cases are also outlined.

摘要

本文回顾了截至1978年8月发表在英文文献中的关于抗精神病药物所致迟发性运动障碍治疗的研究。目前仍没有一种令人满意的迟发性运动障碍治疗方法。停用抗精神病药物可使年轻且无脑损伤的患者症状缓解。矛盾的是,抑制运动障碍最有效的治疗方法是给予抗精神病药物。在运动障碍患者中持续使用抗精神病药物是否会导致不可逆的脑损伤,这一可能性仍有待证实(或证伪)。抗胆碱能药物和多巴胺能药物在迟发性运动障碍的治疗中没有价值。胆碱能药物在这种情况下并未达到其最初令人期待的效果。约三分之一的运动障碍患者似乎对各种非特异性措施有反应。迟发性运动障碍可能至少由两种亚型组成——可逆型和持续型。文中讨论了早期研究的方法学问题以及该领域未来研究的可能性。还概述了针对个别病例的治疗建议。

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