Second-generation antipsychotics and extrapyramidal adverse effects.
Second-generation antipsychotics and extrapyramidal adverse effects.
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DOI：
10.1155/2014/656370
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发表时间：
2014
影响因子：
--
通讯作者：
Cerovac N
中科院分区：
文献类型：
--
作者：
Divac N;Prostran M;Jakovcevski I;Cerovac N
抗精神病药物引起的锥体外系不良反应在第一代抗精神病药物的背景下得到了很好的认识。然而，第二代抗精神病药物的引入，具有非典型的作用机制，特别是较低的多巴胺受体亲和力，临床医生对其潜在的较低导致锥体外系综合征的倾向抱有很高的期望。本文对第二代抗精神病药物和锥体外系综合征的最新文献进行了简要的综述。许多研究已经检验了第一代和第二代抗精神病药物治疗锥体外系综合征的发生率和严重程度。这些研究中的大多数都清楚地表明，第二代药物确实会发生锥体外系综合征，尽管与第一代药物相比，发生率较低。危险因素是选择特定的第二代药物(氯氮平风险最低，利培酮风险最高)、高剂量、既往锥体外系症状病史和合并症。此外，在比较研究中，第一代比较器的选择对结果有很大影响。即使在第二代抗精神病药物的时代，锥体外系综合征仍然具有重要的临床意义。锥体外系综合征的发生率和严重程度在这些抗精神病药物中有所不同，但事实是这些药物在耐受性方面没有达到预期。
Antipsychotic-induced extrapyramidal adverse effects are well recognized in the context of first-generation antipsychotic drugs. However, the introduction of second-generation antipsychotics, with atypical mechanism of action, especially lower dopamine receptors affinity, was met with great expectations among clinicians regarding their potentially lower propensity to cause extrapyramidal syndrome. This review gives a brief summary of the recent literature relevant to second-generation antipsychotics and extrapyramidal syndrome. Numerous studies have examined the incidence and severity of extrapyramidal syndrome with first- and second-generation antipsychotics. The majority of these studies clearly indicate that extrapyramidal syndrome does occur with second-generation agents, though in lower rates in comparison with first generation. Risk factors are the choice of a particular second-generation agent (with clozapine carrying the lowest risk and risperidone the highest), high doses, history of previous extrapyramidal symptoms, and comorbidity. Also, in comparative studies, the choice of a first-generation comparator significantly influences the results. Extrapyramidal syndrome remains clinically important even in the era of second-generation antipsychotics. The incidence and severity of extrapyramidal syndrome differ amongst these antipsychotics, but the fact is that these drugs have not lived up to the expectation regarding their tolerability.
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影响因子：
10.6
作者：
COHEN, BM;KECK, PE;COLE, JO
通讯作者：
COLE, JO
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158.5
作者：
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通讯作者：
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