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1.
抗精神病药物导致的迟发性锥体外系综合征(TES)这个名称由迟发性运动障碍(TD)发展而来,可分为TD、TDT、TA、TT、TM和TP等亚型。作为药物不良反应监察的任务之一,本研究对上海地区七定精神医疗单位进行横断面调查,并对确诊的TES各亚型亚型进行症状评估。结果发现,TES总时点患病率为6.44%,与即往资料比较似有下降趋势。与国内外TES患病率比较,上海最低。TES各亚型均有其临床特点,其严重  相似文献   

2.
住院双相情感障碍患者迟发性运动障碍相关因素分析   总被引:1,自引:0,他引:1  
调查101例双相情感性精神障碍患者迟发性运动障碍(TD)的危险因素。方法用迟发性运动障碍量表(Simpson量表)、认知功能问卷调查,并收集临床资料。对相关因素进行logistic回归分析,判断TD的危险因子。结果TD与抗精神病药治疗时间、因躁狂住院的次数呈正相关。结论长期抗精神病药治疗可能是双相情感性精神障碍患者TD产生的高危因素  相似文献   

3.
迟发性运动障碍出现率及其危险因素的调查分析   总被引:4,自引:0,他引:4  
目的本文调查了住院5年至10年之间病人的迟发性运动障碍(TD)的出现率及其危险因素。方法采用“Simpson迟发性运动障碍评分表”为工具,共调查了107例住院病人。确定有TD的标准是面部、唇部、颌部、舌部、颈部和躯干、上肢和下肢中至少有两个部位具轻度或轻度以上的异常运动。结果TD总的出现率为374%。TD组首次发病年龄显著高于无TD组(t=2.09,P=0.039);服用抗精神病药物的剂量也显著低于无TD组(t=-2.00,P<0.048)。服用抗精神病药的同时联用安坦者,TD出现率显著低于未联用者(χ2=7.1,P<0.01)。结论在我国长期住院病人TD的出现率并不低于西方的报道。发病年龄晚者在服用抗精神病药以后更容易出现TD;抗精神病药与安坦联用者,TD出现率显著低于未联用者  相似文献   

4.
迟发性运动障碍与吸烟的关系黄雄,许美庭,黄杏梅,高广斌迟发性运动障碍(T8rdiveDvskinesiaTD)是饮用抗精神病药物过程中出现的一种严重副反应,劫团结今未明,近年来许多研究表明,它与许多因素有为但吸烟对TD产生是否有影响,国内外报道甚少....  相似文献   

5.
调查33例双相情感性精神障碍患者迟发性运动障碍(TD)有关的因素,并评估其认知功能。用迟发性运动障碍量表(Simpson量表)、认知功能问卷调查,并收集临床资料。结果发现,有TD的比无TD的患者住院总次数多,因躁狂发作住院的次数多,抗精神病药治疗时间长,平均日剂量高,合并抗胆碱能药时间长。表明长期、高剂量抗精神病药治疗可能是双相情感性精神障碍病人TD产生的高危因素,且长期并用抗胆碱能药增加TD产生的危险。有无TD的病人认知功能并无差异。  相似文献   

6.
目的:探讨抗精神病药所致的迟发性运动障碍(TD)的相关因素。方法:用不自主运动量表(AIMS),锥体外系副反应量表(RSESE)评定确认TD、急性锥体外系副反应(EPS)存在,建立对照组。对所得临床资料进行统计学分析。结果:TD组年轻男性多,总服药时间长,服药剂量高,高效价药使用多,既往EPS次数多,情感性精神障碍患者服药剂量比精神分裂症患者明显低。TD严重程度与各临床变量无显著相关性,AIMS≤  相似文献   

7.
对情感性精神障碍患者出现药源性锥体外系症状(EPS)研究较少,EPS与锂盐的关系尚不清楚。有研究发现,接受抗精神病药治疗的情感性精神障碍患者比精神分裂症患者对EPS(包括迟发性运动障碍,TD)有较高的易感性[1]。有关锂盐与EPS间的关系,动物实验[...  相似文献   

8.
目的:调查撤药出现的运动障碍(WE-D)是否为迟发性运动障碍(TD)的早期征象。方法:71例精神分裂症病人停药2周,于停药前及停药后第2周末评定迟发性运动障碍量表(Simp-son量表)及阴性症状量表,收集临床资料,并随访半年。结果:无TD组病人年龄、病程显著低于WE-D组及TD组病人;WE-D组与TD组病人间年龄、病程、抗精神病药治疗持续时间、平均剂量及阴性症状间无显著差异。结论:WE-D可能是TD的一个早期表现或为一隐匿性运动障碍  相似文献   

9.
为了解泰必利治疗迟发性运动障碍(TD)的疗效,本文对此进行了研究,现报告于后。1对象与方法对我院260例住院患者以异常不自主动作评定量表(AIMS)和迟发性运动量表(TDRS)进行迟发性运动障碍筛选,凡AIMS评分大于2分者视为可疑病例,共计20例;然后对本组患者使用海俄辛0.3mg治疗,每日两次,连续3天,用药期间不自主动作消失,缓解者作为排除TD。若症状加重或不变则为入组对象,并排除其它原因所致的异常运动,共计16例。其中男10例,女6例。年龄20~60岁,平均48岁。精神病程3~49年,平…  相似文献   

10.
目的:评估抗精神病药对迟发性运动障碍(TD)的掩盖,即隐性运动障碍(covert dyskine-sia)状况。方法应用Simpson运动障碍评分表评定TD。入组的69例病人有23例病人完成了减药之前、停药三周后和再服药四个月后的TD评定,69例次检查都给于隶像,并且两个评定者按照录像独立评定TD是否存在,评定TD的一致性良好(ICC=0.75)。结果完成整个调查的23例病人中,减药前TD出现率为  相似文献   

11.
Abnormal involuntary dyskinetic movements in schizophrenia patients have been documented for more than 140 years. Clinicians should distinguish between two kinds of disturbances—spontaneous dyskinetic movements and movements induced by psychotropic medications—which may look familiar clinically. As a modern term, tardive dyskinesia (TD) is a potentially permanent neurological hyperkinetic movement disorder that occurs after months or years of taking psychotropic drugs. Several distinct forms of TD exist, specifically tardive akathisia, tardive blepharospasm, tardive dystonia, tardive gait, tardive myoclonus, tardive tremor, and tardive tics, and they have different pathophysiologies and treatment. The pathogenesis of TD remains unclear, and the pathophysiology is complex and multifactorial. Moreover, there is solid evidence of a genetic predisposition to TD. This article summarizes recent relevant publications concerning TD and the most recent studies regarding treatment of this disorder with antioxidative agents.  相似文献   

12.
A comparison of severe tardive dystonia and severe tardive dyskinesia   总被引:1,自引:0,他引:1  
The authors present a demographic study comparing tardive dystonia with severe tardive dyskinesia (TD) patients. Tardive dystonia was more common among young men, while severe TD was more common in older women. Neuroleptics were distributed equally in both groups before the onset of the movement disorders. Drug-free periods were common in the history of severe TD than in tardive dystonia patients.  相似文献   

13.
Psychiatric patients in a prospective study on tardive dyskinesia (TD) development were psychometrically evaluated before TD onset to see whether cognitive impairment predisposes an individual to greater risk for TD. It was found that patients with TD showed more preexisting cognitive impairment than did the non-TD controls.  相似文献   

14.
Recognition of tardive dyskinesia (TD) and other neuroleptic, drug-induced, extrapyramidal side effects presents a major challenge in modern clinical psychopharmacology. Failure to recognize these disorders can lead to poor patient care and may contribute to societal pressure for external control of psychiatric practice. This study reports the occurrence of tardive dyskinesia and drug-induced parkinsonism (DIP) in 101 inpatients, and documents underrecognition of both disorders by resident physicians. Researchers noted TD in 28% of cases and residents only described TD (or symptoms of TD) in 12%. The researcher determined DIP prevalence rate of 26% contrasted with an 11% rate found by residents. Patients with psychotic disorders were more likely than other patients to have researcher-identified TD, whereas DIP (researcher cases) occurred more often in patients with affective diagnoses. Residents tended to miss milder cases of TD, and to miss DIP in younger patients and in patients with affective disorders. Improved teaching and clinical exams are recommended to improve recognition.  相似文献   

15.
The clinical features, outcomes, differential diagnoses, epidemiology, risk factors, and treatment approaches to tardive drug-induced extrapyramidal syndromes (EPS) are reviewed. Tardive forms of dyskinesia (TD), dystonia (TDt), akathisia (TA), Gilles de la Tourette syndrome (TGTS), myoclonus (TM), and parkinsonism (TP) are described. Moreover, pharmacological and topographical subtypes of TD are discussed. While TD, TDt, and TA are clearly delineated syndromes, there are limited data on TGTS, TM, and the questionable TP. TDt is distinguished from TD by clinical and treatment-related variables. Epidemiological studies provide evidence of better prognosis for TD compared with both TDt and TA. Two distinct groups of variables were found to be associated with a higher risk for TD: an exogenous factor (neuroleptic treatment variables and alcohol or drug abuse) and a factor of predisposition (elderly, female, affective disorder diagnosis, presence of EPS, diabetes mellitus type II, and signs of central vulnerability). In contrast, being younger and male was associated with TDt. A significant relationship between the hyperkinetic forms of tardive EPS was confirmed. Therapeutic strategy differs for the mild, moderate, and severe forms of tardive EPS. Using low doses of antipsychotics is a good preventive approach. Reducing the dose or switching to an atypical antipsychotic is the usual, but not yet fully explored, first therapeutic step. Clozapine, an antipsychotic with antidyskinetic and antidystonic effectiveness, is the second treatment step. Various suppressors of tardive movements were tested in controlled trials, mainly in TD. GABAergic benzodiazepines (clonazepam), adrenergic antagonists (propranolol, clonidine), antioxidants (alpha-tocopherol), and calcium channel blockers (nifedipine) are useful in the third step of treatment of more severe tardive EPS. Unlike TD, TDt and (partially) TA improve on higher doses of anticholinergic medication. Local injection of botulinum A toxin markedly ameliorates focal tardive dystonia over several months. Less verified therapeutic interventions are discussed.  相似文献   

16.
OBJECTIVE: Instrumental methods to measure tardive dyskinesia (TD) have been introduced in the last few years to try to eliminate the differences in inter-rater reliability. After eliminating variations attributed to the use of different raters, it is clear that TD frequently shows fluctuations in severity contributing to a low test-retest reliability. In the present study the diurnal variability of dyskinetic movements was explored by a computerized technique using digital imaging processing to measure orofacial movements. METHOD: Ten patients with persistent tardive dyskinesia were assessed three times a day once a week for four consecutive weeks. RESULTS: Four patients had significant diurnal variations in the severity of dyskinetic movements and six did not have significant variations. The period of time between waking and the assessment, the severity of dyskinetic movements, and smoking were significantly different between these two groups. CONCLUSION: Diurnal variations, particularly in relation to sleeping and smoking patterns, may need to be taken into account during longitudinal studies of tardive dyskinesia.  相似文献   

17.
The effect of tardive dyskinesia (TD) on body weight has been studied longitudinally in 14 subjects suffering from severe TD, as rated by the Smith Rating Scale. Patients with trunk and extremity movements showed no reduction in their body weight. However, three of four patients who exhibited respiratory TD, with or without oesophageal involvement, were found to have a significant reduction in their body weight after the appearance of TD, as compared to their condition before.  相似文献   

18.
BACKGROUND: Tardive dyskinesia and other delayed-onset abnormal involuntary movement disorders may occur as a result of the use of psychotropic drugs. A distinction is usually made between classic tardive dyskinesia (TD) (orobuccal-lingual-facial) and tardive dystonia, tardive tremor (TT), tardive akathisia, and other related syndromes. In spite of the development of atypical antipsychotics with fewer side effects, tardive movement disorders nevertheless continue to present a significant clinical and therapeutic challenge. Several reports have suggested that donepezil may be helpful in the treatment of TD. METHOD: A preliminary study was conducted of 7 patients (5 women and 2 men) enrolled over a period of 6 months who had been experiencing TT for a period of at least 1 year. The ages of the patients ranged from 64 to 79 years, and all patients were on stable antipsychotic therapy. Donepezil was added to their usual treatment for 8 weeks. The severity of patients' extrapyramidal symptoms was assessed using the tremor subscale of the Simpson-Angus Scale (SAS) and self-rated with a modification of the Clinical Global Impressions scale, the Subjective Clinical Improvement Impression scale. The clinical response was evaluated by comparing the rating scores at baseline prior to donepezil treatment and every 2 weeks thereafter. RESULTS: The addition of donepezil (up to 10 mg/day) was associated with a clinically significant improvement (from 37.5% to 63.6%) on the SAS tremor subscale following 4 weeks of therapy. Only 1 patient discontinued follow-up due to side effects. CONCLUSION: The results suggest that donepezil may be effective in the treatment of TT, and this finding should be evaluated further by a randomized controlled study.  相似文献   

19.
The authors examined the effect of tandospirone on tardive dyskinesia (TD) and parkinsonian symptoms in an open study. Tandospirone did not bring about any favourable effect on TD, but it had a good effect on the parkinsonian symptoms.  相似文献   

20.
Neurodegenerative processes may be involved in the pathogenesis of tardive dyskinesia (TD). Accumulating evidence suggests that brain-derived neurotrophic factor (BDNF) plays a critical role in the maintenance of functional neurons. The present study was to examine plasma BDNF levels and the relationship among BDNF level, psychopathological and tardive dyskinesia symptoms in schizophrenic patients with TD. Eighty schizophrenic patients with TD were compared with 45 schizophrenic patients without TD, as well as with 45 age-, sex-matched normal controls. The severity of TD was assessed using the Abnormal Involuntary Movement Scale (AIMS). The psychopathology of patients was assessed by the Positive and Negative Syndrome Scale (PANSS). Plasma BDNF levels were measured by sandwich enzyme-linked immunosorbent assay (ELISA). The results showed that the patients with TD had lower plasma BDNF levels than those without TD, and than that of normal controls. In the patients with TD, plasma BDNF levels was inversely correlated with AIMS total score, and with PANSS negative subscore. Female patients had significantly lower plasma BDNF levels than male TD patients. Our results suggest that decreased BDNF may play an important role in the pathophysiology of TD. There may be a relationship between decreased BDNF levels and dyskinetic movements associated with TD.  相似文献   

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