Trosch R M, Friedman J H, Lannon M C, Pahwa R, Smith D, Seeberger L C, O'Brien C F, LeWitt P A, Koller W C
Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA.
Mov Disord. 1998 May;13(3):377-82. doi: 10.1002/mds.870130302.
We conducted a multicentered, retrospective review of clozapine's (CZP) effects on a range of psychiatric, sleep, cognitive, motor, and sensory disorders in Parkinson's disease (PD). Therapeutic outcomes and adverse events were compared with varying prescribing practices at participating sites. The medical records of 172 consecutive PD patients treated with CZP at four movement disorder clinics were reviewed. Low-dose CZP improved psychiatric symptoms of psychosis, anxiety, depression, hypersexuality, sleep disturbance, and akathisia. Tremor, torticollis, limb dystonia, and pain showed modest rates of improvement. Twenty-three percent of patients withdrew as a result of adverse events or treatment failure. Inpatient CZP initiation did not improve therapeutic efficacy, or reduce adverse events or the withdrawal rate. Low-dose CZP in the outpatient setting is generally an effective and well-tolerated treatment for many of the psychiatric, sleep, motor, and sensory disturbances common to late-stage PD.
我们对氯氮平（CZP）对帕金森病（PD）一系列精神、睡眠、认知、运动和感觉障碍的影响进行了一项多中心回顾性研究。将治疗结果和不良事件与参与研究地点不同的处方实践进行了比较。对四家运动障碍诊所连续接受CZP治疗的172例PD患者的病历进行了回顾。低剂量CZP改善了精神病性症状、焦虑、抑郁、性欲亢进、睡眠障碍和静坐不能等精神症状。震颤、斜颈、肢体肌张力障碍和疼痛显示出适度的改善率。23%的患者因不良事件或治疗失败而退出。住院开始使用CZP并未提高治疗效果，也未减少不良事件或退出率。门诊低剂量CZP通常是治疗晚期PD常见的许多精神、睡眠、运动和感觉障碍的有效且耐受性良好的治疗方法。
