Feltner D E, Hertzman M
National Institute of Mental Health, St. Elizabeths Hospital, Washington, D.C. 20032.
Hosp Community Psychiatry. 1993 Jan;44(1):25-34. doi: 10.1176/ps.44.1.25.
About 20 percent of patients receiving long-term treatment with neuroleptic medications develop tardive dyskinesia. A 1988 review of treatment studies for the disorder found that 40 percent of patients showed at least 50 percent improvement in symptoms. This paper reviews studies published since 1984, including those not reviewed in 1988, to learn whether new or improved treatments for the disorder have been developed.
Twenty-five open, blind, or double-blind studies (with a minimum of five patients) published between 1984 and May 1992 were examined. The studies involved neuroleptics, including clozapine, dopaminergic and dopamine-depleting agents, GABAergic drugs, vitamin E, calcium channel blockers, and adrenergic drugs.
Overall, only 26 percent of patients who participated in the studies reviewed had a 50 percent or greater reduction in symptoms. The authors conclude that treatment of tardive dyskinesia remains a highly individual process and recommend that future studies be more carefully designed.
接受抗精神病药物长期治疗的患者中约20%会出现迟发性运动障碍。1988年对该疾病治疗研究的综述发现，40%的患者症状改善至少50%。本文回顾了1984年以来发表的研究，包括1988年未被综述的研究，以了解是否已开发出针对该疾病的新的或改进的治疗方法。
对1984年至1992年5月间发表的25项开放、盲法或双盲研究（每组至少5名患者）进行了审查。这些研究涉及抗精神病药物，包括氯氮平、多巴胺能和多巴胺耗竭剂、GABA能药物、维生素E、钙通道阻滞剂和肾上腺素能药物。
总体而言，参与综述研究的患者中只有26%的症状减轻了50%或更多。作者得出结论，迟发性运动障碍的治疗仍然是一个高度个体化的过程，并建议未来的研究应设计得更加严谨。
