Gleason P P, Conigliaro R L
Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pennsylvania, USA.
Pharmacotherapy. 1997 May-Jun;17(3):617-21.
Neuroleptic malignant syndrome is thought to be a result of dopamine D2 receptor blockade in the striatum of the basal ganglia. Risperidone, a benzisoxazole derivative antipsychotic, has high serotonin 5-HT2 receptor blockade and dose-related D2 receptor blockade. The high ratio is believed to impart the low frequency of extrapyramidal symptoms with risperidone at low dosages. With this low frequency of extrapyramidal symptoms, it was thought the frequency of neuroleptic malignant syndrome might also be lowered. A 73-year-old woman developed neuroleptic malignant syndrome after monotherapy with risperidone. The syndrome reversed after discontinuing risperidone and starting treatment with dantrolene and bromocriptine. It appears that the protection from extrapyramidal side effects observed with risperidone does not ensure protection from neuroleptic malignant syndrome.
抗精神病药恶性综合征被认为是基底神经节纹状体中多巴胺D2受体阻断的结果。利培酮是一种苯并异恶唑衍生物抗精神病药，具有高血清素5-HT2受体阻断作用和剂量相关的D2受体阻断作用。这种高比例被认为是利培酮在低剂量时锥体外系症状发生率低的原因。鉴于锥体外系症状发生率低，人们认为抗精神病药恶性综合征的发生率也可能降低。一名73岁女性在接受利培酮单药治疗后出现了抗精神病药恶性综合征。停用利培酮并开始使用丹曲林和溴隐亭治疗后，该综合征得到缓解。看来，利培酮所观察到的对锥体外系副作用的防护并不能确保预防抗精神病药恶性综合征。
