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迟发性运动障碍、氯氮平与治疗反应

Tardive dyskinesia, clozapine, and treatment response.

作者信息

Dalack G W, Becks L, Meador-Woodruff J H

机构信息

Ann Arbor VAMC, Michigan, USA.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 1998 May;22(4):567-73. doi: 10.1016/s0278-5846(98)00026-8.

DOI:10.1016/s0278-5846(98)00026-8
PMID:9682273
Abstract
  1. Tardive Dyskinesia (TD) can be a serious consequence of the use of antipsychotic medications to treat psychotic illness. There is evidence to suggest that the atypical antipsychotic, clozapine, is less likely to cause, and may even ameliorate TD. 2. The authors reviewed their experience regarding clozapine and TD among patients in their Clozapine Clinic, and summarize some of the recent clinical literature in this area. 3. Retrospective review of chart records for 13 patients was carried out. Comparisons of TD and symptom rating scales were made: 1) between groups (with and without TD) at baseline; 2) between individuals (self as own control) in the TD group at baseline and at the end of the follow-up period. 4. Subjects with and without TD at baseline had a significant decrease in psychiatric symptoms over the course of treatment. 5. In those with TD at baseline, mean Abnormal Involuntary Movement Scale (AIMS) score decreased by 85% over 10.3 +/- 5.5 (mean +/- S.D.) months at a dose of 358 +/- 196 mg/day of clozapine. 6. The data, and the recently published clinical literature on clozapine and TD, continue to support the striking utility of clozapine for chronically psychotic patients, and particularly those with TD.
摘要
  1. 迟发性运动障碍(TD)可能是使用抗精神病药物治疗精神疾病的严重后果。有证据表明,非典型抗精神病药物氯氮平引发TD的可能性较小,甚至可能改善TD症状。2. 作者回顾了他们在氯氮平诊所中关于氯氮平与TD的治疗经验,并总结了该领域一些近期的临床文献。3. 对13例患者的病历记录进行了回顾性分析。对TD和症状评定量表进行了比较:1)基线时两组(有TD和无TD)之间;2)TD组内个体在基线时和随访期末(自身作为对照)。4. 基线时有TD和无TD的受试者在治疗过程中精神症状均有显著减轻。5. 基线时有TD的患者,在氯氮平剂量为358±196毫克/天的情况下,平均异常不自主运动量表(AIMS)评分在10.3±5.5(平均±标准差)个月内下降了85%。6. 这些数据以及最近发表的关于氯氮平与TD的临床文献,继续支持氯氮平对慢性精神病患者,尤其是对患有TD的患者具有显著疗效。

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