Flupentixol Decanoate-related Tardive Dyskinesia

Flupentixol Decanoate相關之遲發性運動異常

劉秋平(Chiou-Pin Liou) ； 方俊凱(Chun-Kai Fang) ； 徐堅棋(Shien-Chi Hsu)

《台灣精神醫學》 20卷3期 (2006/09) Pp. 230-239

https://doi.org/10.29478/TJP.200609.0008

摘要

目的：flupentixol decanoate長效注射針劑在某些急性慢性精神病人較口服抗精神病藥物更為適用，我們對此藥所發生之遲發性運動異常做臨床分析。方法：我們檢視261位接受flupentixol decanoate治療的病人，以SMITHTRIMS Tardive Dyskinesia量表評估其發生不正常運動程度，包括口面部、上下肢和步伐時等。結果：其中發現54位(20.7%)具有遲發性運動異常，男性有15位(28.3%)，女性39位(18.7%)，結果顯示，其嚴重程度和服用精神病藥物劑量的大小，時間的長短成正相關性，和曾否使用抗膽鹼藥物沒有顯著的差異，使用抗膽鹼藥物治療的33位病人中，其藥物劑量的大小與運動異常嚴重程度呈正相關，但未達統計意義。實驗同時發現運動異常嚴重程度與病人年齡大小明顯相關，但與男女性別沒有關係。使用電氣痙攣治療的17位病人與未使用之37位病人比較，前者異動現象之嚴重程度明顯較高。結論：flupentixol decanoate長效抗精神病針劑所發生之遲發性運動異常，其臨床特徵在發生和嚴重程度有不同的顯著特質，另外，54位發生病狀患者中，經過三個月追，發現有5位(9.3%)，其異動現象自然消失。

關鍵字

flupentixol decanoate ； 遲發性運動異常 ； 長效型抗精神病藥 ； 盛行率

並列摘要

Objective: Flupentixol decanoate was commonly used in the treatment of acute or chronic psychiatric patients who are unable to tolerate oral antipsychotics. This study investigated the clinical manifestations of tardive dyskinesia(TD) in patients treated with flupenthixol. Methods: Tardive dyskinesia was observed in 261 psychiatric patients treated with flupentixol decanoate injection based on the Smith-TRIMS TD scale, an instrument which assesses the occurrence and severity of abnormal movements in the orofacial area, upper and lower extremities. Data on clinical and drug history, the history of electroconvulsive therapy and anticholinergic management, and the ages of patients were analyzed for their association with the prevalence and severity of TD. Results: TD was found in 54(20.7%) of the patients, including 15(28.3%) males and 39(18.7%) females. The dosage and duration of neuroleptic exposure were significantly associated with TD severity. However, no relationship between anticholinergic management and TD severity was found in 33 patients. A positive correlation between the severity of TD and the age of the patients was also noted. The prevalence of TD in males was greater than that in females, but this difference was not significant. The 17 patients who had undergone electroconvulsive therapy had higher severity of TD. During three months of follow-up observation, TD symptoms disappeared spontaneously in 5 patients (9.3%). Conclusion: Flupentixol decanoate of injection was significantly associated with the occurrence and severity of TD.

並列關鍵字

flupentixol decanoate ； tardive dyskinesia ； depot neuroleptic ； prevalence rate

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