Perry P J
College of Medicine, University of Iowa, Iowa City 42242-1123, USA.
Am J Health Syst Pharm. 1995 Feb 1;52(3 Suppl 1):S9-14. doi: 10.1093/ajhp/52.3_Suppl_1.S9.
The clinical use of clozapine and risperidone is reviewed. Traditional antipsychotic drugs are effective for treating the positive symptoms of schizophrenia but have little or no effect on the negative symptoms of this disease. Newer antipsychotic agents, such as clozapine and risperidone, are effective for treating both positive and negative symptoms in acutely ill and treatment-resistant patients. Clozapine and risperidone also have a lower incidence of extrapyramidal symptoms (EPS) than traditional antipsychotic drugs. Three hypotheses have been proposed to account for the newer agents' ability to relieve negative symptoms: (1) Improvement in negative symptoms may be linked to improvement in positive symptoms. (2) Negative symptoms may improve in the absence of the EPS often caused by traditional agents. (3) The newer antipsychotic agents may directly affect the neural circuits that trigger negative symptoms.
本文综述了氯氮平和利培酮的临床应用。传统抗精神病药物对治疗精神分裂症的阳性症状有效，但对该疾病的阴性症状几乎没有影响或完全无效。新型抗精神病药物，如氯氮平和利培酮，对急性病患者和难治性患者的阳性和阴性症状均有效。与传统抗精神病药物相比，氯氮平和利培酮的锥体外系症状（EPS）发生率也较低。关于新型药物缓解阴性症状的能力，已提出了三种假说：（1）阴性症状的改善可能与阳性症状的改善有关。（2）在没有传统药物常引起的EPS的情况下，阴性症状可能会改善。（3）新型抗精神病药物可能直接影响引发阴性症状的神经回路。
