Medical College of Georgia, Augusta, Georgia, USA.
J Clin Psychiatry. 2019 Dec 3;80(6):NU18041BR2C. doi: 10.4088/JCP.NU18041BR2C.
Dopamine receptor blocking agents-including antipsychotics-can produce tardive dyskinesia (TD). First-generation antipsychotics were effective in treating schizophrenia and severe forms of bipolar disorder; however, they were associated with substantial extrapyramidal effects, especially at high doses. Second-generation antipsychotics are effective and produce fewer adverse movement effects; nevertheless, the risk for TD was not eliminated. Tardive dyskinesia can be distressing to patients with good insight into their illness and the movements, especially if they are working and in relationships, and should be treated to improve psychosocial outcomes. In patients with poor insight into their illness and lack of awareness of their TD symptoms, clinicians should treat TD if it causes severe impairment.
多巴胺受体阻断剂,包括抗精神病药,可引起迟发性运动障碍(TD)。第一代抗精神病药在治疗精神分裂症和严重双相情感障碍方面有效;然而,它们与明显的锥体外系作用相关,尤其是在高剂量时。第二代抗精神病药有效,产生的运动不良影响较少;然而,TD 的风险并未消除。迟发性运动障碍会使对疾病和运动有良好洞察力的患者感到痛苦,特别是如果他们在工作和人际关系中,应进行治疗以改善心理社会结局。对于对疾病缺乏洞察力且对 TD 症状缺乏意识的患者,如果 TD 导致严重的障碍,临床医生应治疗 TD。