Retz W, Rösler M, Sitzmann L, Becker T
Psychiatrische Universitätsklink Würzburg.
Fortschr Neurol Psychiatr. 1997 Aug;65(8):347-53. doi: 10.1055/s-2007-996339.
The atypical antipsychotic clozapine has been reported to be effective in otherwise refractory psychoses. This, and its low potential for inducing extrapyramidal side effects and tardive dyskinesia, predestines this drug for the treatment of psychotic disorders in late life. However, not much is known about the efficacy, safety and pharmacokinetics of clozapine in the treatment of aged patients. There are some studies and reports available about clozapine in the treatment of psychosis in patients suffering from dementia, schizophrenia and Parkinson's disease, which are reported here. They give some evidence that even low doses of clozapine are effective in controlling psychotic symptoms in the elderly. To avoid side effects, patient-specific factors and changes of pharmacokinetics in the elderly have to be considered. However, side effects including sedation, delirium, posturnal hypotension and the risk of agranulocytosis in particular limits the use of clozapine in elderly patients.
据报道，非典型抗精神病药物氯氮平对其他治疗方法难治的精神病有效。因其诱发锥体外系副作用和迟发性运动障碍的可能性较低，该药注定适用于治疗老年期精神障碍。然而，关于氯氮平治疗老年患者的疗效、安全性和药代动力学，人们了解得并不多。本文报道了一些关于氯氮平治疗痴呆、精神分裂症和帕金森病患者精神病的研究和报告。这些研究和报告提供了一些证据，表明即使低剂量的氯氮平也能有效控制老年人的精神症状。为避免副作用，必须考虑老年人的个体因素和药代动力学变化。然而，包括镇静、谵妄、体位性低血压，尤其是粒细胞缺乏症风险等副作用，特别限制了氯氮平在老年患者中的使用。
