超敏性精神病

本介绍药物超敏性精神病的临床表现，诊断，治疗与可能机制。     

迟发性运动障碍与抗精神病药物治疗关系的研究

目的观察迟发性运动障的发生与长期应用抗精神病药物的关系。方法选取北京回龙观医院长期住院的患者,符合CCMD-3精神分裂症的诊断标准,抗精神病药剂量恒定维持治疗6个月。排除器质性疾病及其它神经精神疾患。先用Simpson迟发性运动专业量表进行全院患者筛选,最终选出合乎要求病例109例,再用AIMS量表评定,依据患者用药情况分为三组,典型抗精神病药组（包括氯丙嗪、奋乃静、氟哌啶醇、安棕酯）、氯氮平组、利培酮组,使用SPSS10.0,采用独立样本t检验、单因素方差分析,分析三组药物与TD的相关性。结果利培酮组的AIMS总分显著低于典型抗精神病药组（p=0.032）,与氯氮平组无显著差异（P=0.275）。结论利培酮组,氯氮平组致TD症状的严重程度偏低,或对TD症状有一定抑制或治疗作用。     

多巴胺D2受体基因与迟发性运动障碍关联研究

目的探讨DRD2基因TaqI多态性的分布与迟发性运动障碍(TD)的关联性.方法应用聚合酶链反应-限制性片段长度多态的方法,检测100例精神分裂症伴TD患者、60例无TD患者和102名正常人DRD2基因TaqI多态性,比较各组等位基因和基因型频率分布的差异.结果经吻合度检验,精神分裂症伴有TD组、无TD组和正常对照组DRD2基因各基因型的分布均符合Hardy-Weinberg平衡法则(x2=0.242,0.208,0.002,υ均=1,P均＞0.05);经比较,显示各基因型及等位基因在各组间分布无显著性差异(经Z检验,υ均=1,P均＞0.05);TD患者DRD2基因多态分布在不同性别之间无显著性差异(P＞0.05);在TD组中,基因型频数及等位基因频数与病程、服药时间、药物、剂量和AIM评分无显著性意义(P＞0.05).结论DRD2基因TaqI多态性可能与TD的发生无关联性.     

抗精神病药的抗多巴胺能不良反应

典型抗精神病药的作用机制就是阻断多巴胺D2受体。在改善阳性精神病症状的同时,也会引起一系列不良反应。本文拟综述这些不良反应。     

典型抗精神病药的不良反应与神经递质效应

既往是按照脏器系统描述典型抗精神病药的不良反应的。由于不良反应种类浩繁,难以一一记住,加之不良反应机制交叉重叠,难以一一梳理清楚。我们按照神经递质效应描述典型抗精神病药的不良反应,是从机制上归纳这些不良反应,使之易读、易懂、易记、易归纳,这种归纳能涵盖典型抗精神病药不良反应的4／5以上,尽管尚有肝脏、骨髓、皮肤和妊娠不良反应不能用神经递质效应所解释。     

非典型抗精神病药引发迟发性运动障碍的研究现状

本文主要综述了非典型抗精神病药引起迟发性运动障碍的发病率明显降低及可能的病理生理机制。     

多巴胺D2受体基因的TaqI A多态性与迟发性运动障碍的关联分析

目的　研究多巴胺D2受体 (DRD2 )基因TaqIA多态性与精神分裂症伴迟发性运动障碍 (TD)的相关性。方法　使用异常不自主运动量表 (AIMS)评定精神分裂症患者有无TD及TD严重程度 ,并采用简明精神病评定量表 (BPRS)评定患者精神症状 ;应用聚合酶链反应 (PCR)—限制性片段长度多态性 (RFLP)法分析TD组和非TD组的DRD2基因的TaqIA等位基因频率和基因型分布。结果　DRD2基因TaqIA的等位基因频率和基因型分布在TD组与非TD组之间均无显著性差异 ,且不同基因型间的AIMS总分值也无显著性差异。结论　在中国汉族男性精神分裂症患者中DRD2基因的TaqIA多态性可能不是影响TD发生的主要危险因素。     

抗精神病药所致迟发性运动障碍患者血清白细胞介素-2的测定

<正>有研究认为白细胞介素-2(IL-2)可能参与了迟发性运动障碍(TD)的病理机制。本研究通过比较精神分裂症伴发和不伴发TD者与正常人群血清IL-2水平以及IL-2水平与TD严重程度的相关性,探讨TD可能的发病机制。1对象和方法为2013年10月至2014年2月我院符合ICD-10精神分裂症诊断标准的住院患者;年龄18~75岁;长期规律服用抗     

迟发性运动障碍治疗的五步法

本文介绍迟发性运动障碍（TD）治疗的五步法。     

抗精神病药物所致迟发性肌张力障碍的诊治1例报道

一般认为迟发性肌张力障碍(Tardive Dystonia,TDt)是迟发性运动障碍(Tardive Dyskinesia,TDk)的一个亚型[1]。近二十年来发现TDt的病理生理、病程、结局及治疗效果均与TDk不同而将两者分开。现有1例其症状表现、诊治经过有一定特点,报道如下。1资料患者,女性,26岁,因渐起凭空闻声、疑人害1年于2005年6月在我院门诊诊断为“偏执型分裂症”,应用“利培酮(维思通)”(2～6mg/d)后症状改善,于2005年8月出现不自主点头、手抖及泌乳等,停“利培酮”改用“氟哌啶醇癸酸酯注射液(哈力多)”肌注(初为每月1次每次100mg,后减为每月1次,每次50mg),并…     

Partial dopamine agonists in the treatment of psychosis

Summary. The discovery and characterization of dopamine in the mammalian brain earned Dr. Arvid Carlsson the Nobel Prize in 2000. Along with his many insights about dopamine pharmacology, came his proposal of the existence and critical role of dopamine autoreceptors in the overall regulation of dopamine-mediated neurotransmission. In this paper, the rationale, the putative mechanisms, and pertinent clinical data are reviewed to support the idea of the clinical relevance of dopamine agonists, especially partial agonists, in the treatment of psychosis. Evidence was gathered for the usefulness of this strategy in schizophrenia in early trials with apomorphine and N-propylnoraporphine (NPA). But clinical relevance was not a reality before the application of (−)-3PPP. These clinical results are presented. Moreover, now a partial dopamine agonist, aripiprazole, has been developed and will likely be marketed by BMS and Otsuka for the treatment of psychosis and will be the first drug in this class to be commercially available. Partial dopamine agonists represent the next new class of antipsychotic drugs, effective in treating schizophrenia. Received March 12, 2001; accepted April 27, 2001     

多巴胺及其受体的研究现状

多巴胺作为中枢神经系统的重要神经递质,主要参与运动、情感和神经内分泌的调节,多巴胺系统是近30年来神经科学研究的焦点问题之一,一些疾病如帕金森病(PD)、精神分裂症、Tourette综合征(TS)、注意缺陷多动障碍(ADHD)等均与多巴胺能神经递质传递障碍有关。在本文中,笔者拟对多巴胺的代谢、功能及多巴胺能受体的特征,以及它们在中枢神经系统的分布和功能作一简要综述。     

Current concepts of pharmacological treatment in schizophrenia

The modern concepts of pharmacotherapy of schizophrenia, with the special emphasis put on new antipsychotic drugs were presented. The attention was put on the need for careful evaluation of the patient's state: the diagnosis, treatment which the patient receives and compliance with the treatment. It was stated that modern concepts of treatment of schizophrenia do not solely rely on the use of modern drugs, but include the multidirectional therapeutic actions with an active participation of the patient and his/her relatives.     

Neurobiological mechanisms and pharmacological treatment options for alcohol craving

In the last years, numerous studies have been performed on neurobiological mechanisms in alcohol craving. Changes in the hypothalamic cortisol pathway and the leptin metabolism, which is also associated with pharmacological interventions, have been of special interest. With acamprosate and naltrexone two substances exist for pharmacotherapy, but recent results about the efficacy are controversial. The clinical profit of disulfiram has been shown, at least in a subgroup of patients. Besides, there are several promising candidate substances. Current investigations focus on a differentiated pharmacotherapy of alcohol dependence, including psychological and genetic factors.     

Current status of research on autism spectrum disorders and offending

An emerging literature on autism spectrum disorders (ASD) and offending has highlighted that these disorders are at times associated with criminal behaviour. Ghaziuddin et al. (1991) reviewed the published literature on this topic from 1944 to 1990 and concluded that there was no clear link between Asperger syndrome (AS) and violent crime. They suggested that people with AS hardly were more likely to commit violent crime than the rest of the population. The present review provides an update on the issues in the earlier review mentioned and presents new issues that have emerged in the past two decades. Currently, there is still no body of evidence to suppose that people with ASD are more prone to commit offences than anyone else. However, a small number of serious crimes can be linked to the core features of ASD. Co-morbid psychiatric disorders are important risk factors for offending in people with ASD. Studies of referred samples have suggested considerable differences in offending among subgroups of people with ASD. Offending has rarely been reported in childhood autism, but is more common in atypical autism (AA) and AS. Literature suggests that people with ASD are potentially overrepresented within the criminal justice system, and that failure to detect ASD among offenders is not uncommon. Insofar as people with AA and AS have offended, it has typically been connected with arson and sexual abuse. But due to lack of valid community based studies of offending relating to people with ASD, these findings must be interpreted with caution.