Hoes M J
Department of Psychiatry, Ziekenhuis Rivierenland, Tiel, The Netherlands.
Pharm World Sci. 1998 Jun;20(3):101-6. doi: 10.1023/a:1008638805406.
Antipsychotic drugs are effective in psychoses, whatever the aetiology of the disorder. The positive symptoms tend to respond more readily. The need for developing new drugs arises from the refractoriness of the negative symptoms, the 10-25% of the patients that are treatment-resistant and the problems of short-, and long-term extrapyramidal side-effects. Thus far, five drugs differing from the classical antipsychotics have been licensed for use: clozapine, olanzepine, risperidone, sertindole and sulpiride, and in at least some European countries quetiapine is now in the final phase of clinical research. This review starts with a brief introduction to symptomatology, is limited to the registered drugs and addresses differences with the classical drugs in pharmacology, pharmacokinetics, clinical aspects and side-effects. Clozapine, risperidone and sulpiride can be considered for clinical use in refractory patients, and these three together with olanzapine and sertindole are candidates when extrapyramidal side-effects cause a clinical problem.
抗精神病药物对各种病因引起的精神病均有效。阳性症状往往更容易得到缓解。开发新药的需求源于阴性症状的难治性、10%至25%的难治性患者以及短期和长期锥体外系副作用问题。迄今为止，已有五种不同于经典抗精神病药物的药物被批准使用：氯氮平、奥氮平、利培酮、舍吲哚和舒必利，并且在至少一些欧洲国家，喹硫平目前正处于临床研究的最后阶段。本综述首先简要介绍症状学，限于已注册的药物，并探讨其在药理学、药代动力学、临床方面和副作用与经典药物的差异。氯氮平、利培酮和舒必利可考虑用于难治性患者的临床治疗，当锥体外系副作用引起临床问题时，这三种药物与奥氮平和舍吲哚都是候选药物。
