Flupentixol Decanoate-related Tardive Dyskinesia

Flupentixol Decanoate相關之遲發性運動異常

10.29478/TJP.200609.0008

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

flupentixol decanoate ； 遲發性運動異常 ； 長效型抗精神病藥 ； 盛行率 ； flupentixol decanoate ； tardive dyskinesia ； depot neuroleptic ； prevalence rate

台灣精神醫學

20卷3期（2006 / 09 / 01）

230 - 239

英文

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。

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.

1. Astrup C,Grimgard A,Hebnes K,Kruse-Jensen A,Lid M(1974).A study of flupenthixol decanoate and pipothiazine undecylenate in schizophrenics.Acta Psychiatr Scand,50,481-491.
2. Browne S,Roe M,Lane A(1996).Quality of life in schizophrenia: relationship to sociodemographic factors, symptomatology and tardive dyskinesia.Acta Psychiatr Scand,94,118-124.
3. Casey DE(1999).Tardive dyskinesia and atypical drugs.Schizophr Res,35,561-566.
4. Chong SA,Mythily, Lum A,Huak CY,Kane J(2002).Tardive dyskinesia and impaired glucose tolerance.Hum Psychopharmacol,17,305-307.
5. Correll CU,Leucht S,Kane JM(2004).Lower risk for tardive dyskinesia associated with second generation antipsychotics: a systematic review of 1-year studies.Am J Psychiatry,161,414-425.
6. Dalery J,d`Amato T(1999).La schizophrenie, recherches aituelles at perspectives.Masson:
7. Degkwitz R,Luzenburger O(1965).Das terminale extrapyramidale Insuffiziens-bzw. Defektsyndrom infolge chronischer Anwondung von Neuroleptika.Nervenarzt,36,173-175.
8. Faurbye A,Rasch PJ,Peterson PB,Brandborg G,Pakkenberg H(1964).Neurological symptoms in pharmacotherapy of psychosis.Acta Psychiat Scand,40,10-27.
9. Glazer W(2000).Expected incidence of tardive dyskinesia associated with atypical antipsychotics.J Clin Psychiatry,61,21-26.
10. Glazer W(2000).Review of the incidence studies of tardive dyskinesia with antipsychotics.J Clin Psychiatry,61,15-20.
11. Gottfries CG(1971).Klinisk prOvning av flupenthixol decanoate som a depa-neuroleptikum.Nord Psykiatr Tidsskr,25,296-303.
12. Jeste DV,Lacro JP,Bailey A,Rockwell E,Harris MJ,Caligiuri MP(1999).Lower incidence of tardive dyskinesia with risperidone compared with haloperidol in older patients.J AM Geriatr Soc,47,716-719.
13. Kane JM,Eerdekens M,Lindenmayer JP(2003).Long-acting injectable resperidone: efficacy and safety of the first long-acting atypical antipsychotic.Am J Psychiatry,160,1125-1132.
14. Morgenstern H,Glazer WM(1993).Identifying risk factors for tardive dyskinesia among long-term outpatients maintained with neuroleptic medications: results of the Yale Tardive Dyskinesia Study.Arch Gen Psychiatry,50,723-733.
15. Oosthuizen PP,Emsley PA,Maritz JS,Turner JA,Keyter N(2003).Incidence of tardive dyskinesia in first-episode psychosis patients treated with low-dose haloperidol.J Clin Psychiatry,64,1075-1080.
16. Price TRP,Levin R(1978).The effect of electroconvulsive therapy on tardive dyskinesia.Am J Psychiatry,135,991-993.
17. Saikia JK,Jorgensen A(1983).Steady-state serum concentrations after cis(Z)-flupentixol decanoate in viscoleo.Psychopharmacology,80,371-373.
18. Tardive dyskinesia(1980).Task Force Report 18.Washington, DC:American Psychiatric Association.
19. Waddington JL(1987).Tardive dyskinesia in schizophrenia and other disorders: Association with aging, cognitive dysfunction, and structural brain pathology in relation to neuroleptic exposure.Hum Psychopharmacol,2,11-22.
20. Yassa R,Jeste DV(1992).Gender difference in tardive dyskinesia: a critical review of the literature.Schizophr Bull,18,701-715.

1. Pao-Yuan Ching,Chih-Chuan Pan,Cheng-Ho Chang(2021)。Tetrabenazine for Treating Neuroleptic-induced Tardive Dyskinesia: A Case Report of a Patient with Chronic Schizophrenia。臺灣精神醫學，35(4)，208-209。