Citrome L
New York University, Orangeburg, USA.
Postgrad Med. 1997 Feb;101(2):207-10, 213-4. doi: 10.3810/pgm.1997.02.166.
New, so-called atypical antipsychotic medications will no doubt supplant the traditional, or "typical," antipsychotic medications, just as the new generation of antidepressant agents has replaced the older tricyclic drugs. At issue with most of the new drugs is not acute efficacy, but long-term tolerability. Side effects must be minimized to enhance compliance and prevent relapse. It appears that many of the new antipsychotic drugs have fewer or less troublesome side effects than the older agents. In addition, the "atypical" antipsychotic agents hold promise for treating refractory schizophrenia. At present, only clozapine, with its risks for agranulocytosis and seizures, is clearly established as a treatment for refractory illness. Risperidone may be an alternative for treatment-resistant schizophrenia, but this has not yet been clearly proved. Olanzapine has recently been introduced. Sertindole should be available soon, and quetiapine and ziprasidone should quickly follow. Safety, efficacy, and cost will guide their use. None of these newer agents have been compared head-to-head with clozapine. More research is needed to place these new drugs into clinical perspective.
新型的所谓非典型抗精神病药物无疑将取代传统的或“典型的”抗精神病药物，就如同新一代抗抑郁药取代了旧的三环类药物一样。大多数新药面临的问题并非急性疗效，而是长期耐受性。必须将副作用降至最低以提高依从性并预防复发。看来许多新型抗精神病药物的副作用比旧药物更少或更不麻烦。此外，“非典型”抗精神病药物有望用于治疗难治性精神分裂症。目前，只有氯氮平因其有粒细胞缺乏症和癫痫发作的风险，被明确确立为难治性疾病的治疗药物。利培酮可能是治疗难治性精神分裂症的一种替代药物，但这尚未得到明确证实。奥氮平最近已被引入。舍吲哚应该很快会上市，喹硫平和齐拉西酮也将很快跟进。安全性、疗效和成本将指导它们的使用。这些新型药物均未与氯氮平进行直接对比研究。需要更多研究以便从临床角度看待这些新药。
