Anticholinergic medication for neuroleptic-induced tardive dyskinesia

 

Abstract

Background

Neuroleptic medication is used extensively to treat people with chronic mental illnesses. However, it is associated with a wide range of adverse effects, including movement disorders. Because of this, many acutely psychotic patients being treated with neuroleptic medication also receive anticholinergic drugs in order to reduce some of the associated movement side-effects.

Objectives

To determine whether the use or the withdrawal of anticholinergic drugs (benzhexol or benztropine or biperiden or orphenadrine or procyclidine or scopolamine or trihexylphenidyl) were clinically effective for the treatment of people with both neuroleptic-induced TD and schizophrenia or other chronic mental illnesses.

Search methods

Electronic searches of Biological Abstracts (1982-2000), Cochrane Schizophrenia Group's Register of trials (2000), EMBASE (1980-2000), LILACS (1982-1996), MEDLINE (1966-2000), PsycLIT (1974-2000), and SCISEARCH (1995) were undertaken. References of all identified studies were searched for further trial citations. Principal authors of trials were contacted.

Selection criteria

Reports identified in the search were included if they were controlled trials dealing with people with neuroleptic-induced TD and schizophrenia or other chronic mental illness who had been randomly allocated to either an anticholinergic agent or to a placebo (or no intervention).

Data collection and analysis

No data could be extracted from the seven randomised controlled trials identified.

Main results

No data were synthesized. The authors have been contacted to provide the relevant information. Two studies were excluded because no data are available and six others are still awaiting further information from the authors.

Authors' conclusions

Based on currently available information, no confident statement can be made about the effectiveness of anticholinergics to treat people with neuroleptic-induced tardive dyskinesia. The same applies for the withdrawal of such medications. Whether the withdrawal of anticholinergics may benefit people with neuroleptic-induced TD, this should be evaluated in a parallel-group, placebo-controlled randomised trial, with adequate sample size and at least 6 weeks of follow up.

 

Plain language summary

Anticholinergic medication for neuroleptic-induced tardive dyskinesia

Synopsis pending.

 

摘要

背景

抗膽鹼藥物治療抗精神病藥引起的遲發性運動障礙

抗精神病藥物被廣泛地使用在治療慢性精神疾患上,然而也會產生相當程度的副作用,其中包括運動障礙疾患. 也因為如此,在治療急性發作的患者時常會主動加上抗膽鹼藥物來減少這樣的副作用

目標

探討使用或停止抗膽鹼藥物(benzhexol或benztropine或biperiden或orphenadrine或procyclidine或scopolamine 或trihexylphenidyl)對於精神分裂症或是其他慢性精神疾病合併出現抗精神病藥物引起的遲發性運動障礙(TD)的患者有無臨床上的效用

搜尋策略

電子搜索Biological Abstracts (1982 – 2000), Cochrane Schizophrenia Group's Register of trials (2000), EMBASE (1980 – 2000), LILACS (1982 – 1996), MEDLINE (1966 – 2000), PsycLIT (1974 – 2000), and SCISEARCH (1995)。對於各個研究所引用的參考文獻也進一步去搜尋以得到更多的試驗,也會去接觸主要的作者

選擇標準

只要是有關精神分裂症或其他慢性精神病合併抗精神病藥物導致遲發性運動障礙而被隨機分配到以抗膽鹼藥物或安慰劑(或不治療)處理的對照試驗都會被納入

資料收集與分析

沒有辦法從七個被找到的隨機對照試驗中擷取資料

主要結論

我們無法綜合數據。進一步向作者要求相關的資訊,其中有兩個研究因為沒有數據提供而被排除,另外六個仍在等待進一步消息

作者結論

根據現有的資料，我們沒有把握說加上或拿掉抗膽鹼藥物對於抗精神病藥物導致的遲發性運動障礙有治療的效果。對於拿掉抗膽鹼藥物是否對於遲發性運動障礙有幫忙, 這就需要用平行組別,有隨機安慰劑對照的試驗，同時又有足夠的樣本數以及至少六周的追蹤才能確知。

翻譯人

本摘要由彰化基督教醫院廖慈凰翻譯

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

目前仍然無法下結論