Weller M, Kornhuber J
Psychiatrische Klinik, Universität Würzburg.
Fortschr Neurol Psychiatr. 1993 Jun;61(6):217-22. doi: 10.1055/s-2007-999090.
Clozapine is an atypical neuroleptic drug characterised by a striking lack of extrapyramidal side effects. Although these features would seem to make clozapin an unlikely agent for the induction of neuroleptic malignant syndrome (NMS), several putative clozapin-related cases of NMS have recently been reported. A reevaluation of these articles raised some doubts on the causal relationship between clozapin therapy and NMS in most cases. We report on the clinical history of nine consecutive NMS patients who required reinstitution of neuroleptic therapy and received clozapine in our clinic. We conclude (1) that the alleged NMS induction by clozapine monotherapy needs further substantiation and (2) that clozapine should be considered a drug of choice if a psychotic relapse necessitates neuroleptic treatment for patients with a history of NMS.
氯氮平是一种非典型抗精神病药物，其特点是明显缺乏锥体外系副作用。尽管这些特性似乎使氯氮平不太可能成为诱发抗精神病药物恶性综合征（NMS）的药物，但最近已有几例推测与氯氮平相关的NMS病例报告。对这些文章的重新评估在大多数情况下对氯氮平治疗与NMS之间的因果关系提出了一些疑问。我们报告了连续9例NMS患者的临床病史，这些患者需要重新开始抗精神病药物治疗，并在我们诊所接受了氯氮平治疗。我们得出结论：（1）氯氮平单药治疗诱发所谓的NMS需要进一步证实；（2）如果精神病复发需要对有NMS病史的患者进行抗精神病药物治疗，氯氮平应被视为首选药物。
