利培酮致迟发性运动障碍不良反应特点分析

目的：分析利培酮导致迟发性运动障碍不良反应的临床用药特点。方法：回顾性分析2004-2015年我院上报的10例利培酮致迟发性运动障碍的药物不良反应，分析患者的性别、年龄、体质量、原患疾病、药物剂型及剂量和发生迟发性运动障碍的潜伏期及临床表现、治疗措施及转归，探讨利培酮导致迟发性运动障碍的特点。结果：10例患者中，男女性各有5例。用药至发生迟发性运动障碍的潜伏期为13~3 505 d，其中用药后1年内发生者6例（占60.0%）。10例患者中，有5例次患者出现颈部异常表现，4例次患者出现肢体扭转，肢体姿势异常或步态异常等症状，6例次患者出现口唇舌部异常动作。10例患者中，出现不良反应后均采取减量、停用利培酮换用其他抗精神病药、密切观察或对症治疗。5例患者好转，4例虽经减量停药或对症处理，仍有后遗症。结论：利培酮所致的迟发性运动障碍临床表现以口唇舌部异常动作，颈部及肢体异常表现为主，其症状多较为严重，可能产生后遗症。另外，小剂量、短期服用利培酮也可能导致迟发性运动障碍，临床用药需谨慎。

Analysis of features of tardive dyskinesias caused by risperidone

OBJECTIVE To analyze the clinical and medical features of adverse reactions of tardive dyskinesia caused by risperidone.METHODS Ten cases of tardive dyskinesia caused by risperidone retrospectively reported from 2004 to 2015 in our hospital were analyzed,to discuss features of adverse reactions of tardive dyskinesia caused by risperidone.Patient gender,age,weight,illness,dosage forms,medicine dose,preclinical and clinical manifestation of tardive dyskinesia,treatment and outcome were analyzed.RESULTS The number of women was equal to that of men in the 10 cases.Incubation period of tardive dyskinesia caused by risperidone was 13-3 505 d.In one year,adverse reactions occurred in 6 cases of patients (60.0%).Of the 10 cases,5 patients had abnormal cervical performance,4 cases of patients had abnormal body torsion,body posture or abnormal gaits.Six patients had abnormal mouth lip or tongue movements.In 10 patients,risperidone was reduced and stopped using after adverse reactions.The patients were closely observed or symptomatically treated.Of the 10 patients,5 cases improved.Although risperidone was reduced or stopped,patients were symptomatically treated,4 cases still had hangovers.CONCLUSION Clinical manifestations of tardive dyskinesia caused by risperidone are given priority to abnormal mouth lip or tongue movement,neck and body abnormality.More symptoms are severe and may produce sequelae.In addition,small dose,short term medication of risperidone may cause tardive dyskinesia,so medicine should be used carefully in clinical practice.