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迟发性运动障碍(TD)是指长期应用抗精神药而导致的一种不自主的多动式锥体外系综合征,病因尚未完全明确,多认为抗精神病药阻断边缘系统多巴胺受体(DA),解除了精神症状,同时也阻断锥体外系的多巴胺受体,出现锥体外系副作用——迟发性运动障碍。现代研究表明:TD与抗精神病药治疗的持续时间呈正相关,这使治疗TD更为棘手。现将有效的治疗方法概述如下:1 作用于DA受体的溴隐亭 溴隐亭为DA受体激动剂,能够选择性激动锥体外系的DA受体,拮抗抗精神病药对DA受体的阻断作用。有报道,根据异常不自主动作评定量表(AIMS),选择服用抗精神病药出现迟发性运动障碍的患者20例,分别服用溴隐亭5mg及安慰剂bid,做双盲自身对照试验,在试验中用AIMS进行评定。结果表明,溴隐亭对TD的治疗效果显著优于安慰剂,显效率为70％,治疗期间未见严重副反应,因此患者用抗精神病药的同时,加用溴隐亭可预防和治疗TD。
Tardive dyskinesia (TD) is an involuntary hyperactivity of extrapyramidal syndrome caused by long-term use of antipsychotics. The cause of the disease is not yet fully understood, and many believe that antipsychotics block the limbic system of dopamine receptors DA), relieve the psychiatric symptoms, but also block the extrapyramidal dopamine receptors, extrapyramidal side effects - tardive dyskinesia. Modern research shows that TD is positively correlated with the duration of antipsychotic treatment, making treatment of TD more challenging. Now effective treatment methods are summarized as follows: 1 acting on the DA receptor bromocriptine is a DA receptor agonist, can selectively activate extrapyramidal DA receptors, antagonist antipsychotics DA receptors Blocking effect. It has been reported, according to abnormal involuntary movement rating scale (AIMS), choose to take antipsychotics appear tardive dyskinesia in patients with 20 cases were taken bromocriptine 5mg and placebo bid, double-blind self-control test, in the AIMS test was used to assess. The results showed that bromocriptine treatment of TD was significantly better than placebo, markedly effective rate of 70%, no serious side effects during treatment, so patients with antipsychotics at the same time, plus bromocriptine can prevent and treat TD .