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首页> 外文期刊>The journal of clinical psychiatry >Antipsychotics in the treatment of schizophrenia: an overview.
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Antipsychotics in the treatment of schizophrenia: an overview.

机译：抗精神病药在精神分裂症的治疗：概述。

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Schizophrenia is characterized by positive, negative, cognitive, disorganization, and mood symptoms. Antipsychotics are the mainstay in the pharmacologic treatment of schizophrenia. Findings concerning efficacy for positive symptoms and disorganization suggest no consistent differences among available antipsychotics, with the exception of clozapine's superior efficacy for treatment-resistant schizophrenia. Efficacy for negative, depressive, and cognitive symptoms appears to be determined by (1) the extent to which reduction in positive symptoms brings about improvement in these other domains and (2) the extent to which extrapyramidal side effects (EPS) and anticholinergic effects (of the antipsychotic and of agents used to treat EPS) exacerbate them. Thus, the ability of antipsychotics to produce a potent antipsychotic effect without EPS and need for concomitant anticholinergic therapy yields multiple therapeutic benefits. In contrast to their broadly similar efficacy, antipsychotics differ markedly in their propensity to cause various adverse effects. Although second-generation antipsychotics (SGAs) have generally been believed to be associated with a lower risk of EPS but a higher risk of metabolic adverse effects than first-generation agents (FGAs), the substantial variation in these and other side effects among agents within both classes indicates that it is not clinically useful to make a categorical distinction between FGAs and SGAs. Choice of antipsychotic medication should be based on individual preference, prior treatment response and side effect experience, medical history and risk factors, and adherence history, with side effect profile a major determinant of antipsychotic choice.
机译：精神分裂症的特征在于阳性，阴性，认知，无序和情绪症状。抗精神病药是精神分裂症药物治疗的主要手段。关于积极症状和混乱的功效的发现表明，除了氯氮平对耐药性精神分裂症的优越疗效外，现有的抗精神病药之间没有一致的差异。消极，抑郁和认知症状的功效似乎由以下因素决定：（1）减轻积极症状在其他方面带来改善的程度，以及（2）锥体束外副作用（EPS）和抗胆碱能作用的程度（的抗精神病药和用于治疗EPS的药物）加重了他们的病情。因此，在没有EPS的情况下抗精神病药产生有效的抗精神病作用的能力以及需要伴随的抗胆碱能疗法产生了多种治疗益处。与它们广泛的功效相反，抗精神病药在引起各种不良反应的倾向上有明显的不同。尽管一般认为第二代抗精神病药（SGA）与第一代药物（FGA）相比具有较低的EPS风险，但具有较高的代谢不良反应风险，但是这些和其他副作用之间的实质性差异这两个类别都表明，在FGA和SGA之间进行分类区分在临床上没有用。抗精神病药物的选择应基于个人的偏爱，先前的治疗反应和副作用经验，病史和危险因素以及依从史，而副作用概况是抗精神病药物选择的主要决定因素。

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