Tonda M E, Guthrie S K
Department of Pharmacy Services, University of Michigan Medical Center, Ann Arbor.
Pharmacotherapy. 1994 Sep-Oct;14(5):543-60.
Acute extrapyramidal syndromes (EPS), including dystonia, parkinsonism, and akathisia, are associated with the use of virtually all neuroleptic agents. They may be alleviated by reducing the neuroleptic dosage, switching to a lower-potency drug, or administering an adjunctive agent such as an anticholinergic, amantadine, benzodiazepine, or beta-blocker. Akathisia may be only partly dispelled by anticholinergics; alternatives are beta-blockers, benzodiazepines, and clonidine. In patients receiving long-term neuroleptic therapy, both the prophylactic use and the duration of treatment with concomitant anti-EPS drugs are controversial. Administration of prophylactic anti-EPS drugs should be based on the likelihood that the patient will develop EPS, as well as the risk of adverse reactions resulting from extended use of the agents in a specific patient. The decision to continue anti-EPS therapy should be reevaluated frequently, especially in elderly patients.
急性锥体外系综合征（EPS），包括肌张力障碍、帕金森症和静坐不能，几乎与所有抗精神病药物的使用都有关联。可通过降低抗精神病药物剂量、换用低效能药物或给予辅助药物（如抗胆碱能药物、金刚烷胺、苯二氮䓬类药物或β受体阻滞剂）来缓解这些症状。静坐不能可能仅部分被抗胆碱能药物消除；其他替代药物有β受体阻滞剂、苯二氮䓬类药物和可乐定。在接受长期抗精神病治疗的患者中，预防性使用抗EPS药物以及联合用药的治疗时长都存在争议。预防性抗EPS药物的使用应基于患者发生EPS的可能性，以及在特定患者中因长期使用这些药物而产生不良反应的风险。应经常重新评估继续抗EPS治疗的决定，尤其是在老年患者中。
