Curtis V A, Kerwin R W
Institute of Psychiatry, Denmark Hill, London, England.
Drug Saf. 1995 Feb;12(2):139-45. doi: 10.2165/00002018-199512020-00006.
The atypical antipsychotic risperidone combines dopaminergic and serotonergic antagonism. This results in a drug that is both clinically effective, reducing positive and negative symptoms of schizophrenia, and has a low incidence of adverse effects. At a dosage of 4 to 8 mg/day, risperidone is comparable to 10 mg/day of haloperidol. This dosage has a low incidence of extrapyramidal adverse effects and is nonsedative, although it may cause orthostatic hypotension. There is no current evidence for specific biochemical and haematological abnormalities associated with risperidone. Although the clinical benefits appear to outweigh the risks, this drug continues to be a relatively expensive treatment option in the UK. There is therefore a need for a formal cost-utility assessment of risperidone and for comparisons between this drug and other atypical neuroleptics.
非典型抗精神病药物利培酮兼具多巴胺能拮抗作用和血清素能拮抗作用。这使得该药物在临床上既有效，能减轻精神分裂症的阳性和阴性症状，又具有较低的不良反应发生率。在每日4至8毫克的剂量下，利培酮与每日10毫克的氟哌啶醇效果相当。此剂量下锥体外系不良反应发生率低且无镇静作用，不过可能会导致体位性低血压。目前尚无证据表明利培酮会引发特定的生化和血液学异常。尽管临床益处似乎大于风险，但在英国，这种药物仍然是一种相对昂贵的治疗选择。因此，有必要对利培酮进行正式的成本效用评估，并将该药物与其他非典型抗精神病药物进行比较。
