항파킨슨 제제가 추체외로 증상의 발생에 미치는 영향

The Effects of Antiparkinson Medications on the Occurrences of Extrapyramidal Symptoms

This study investigated 161 patients receiving antipsychotic medication and benztropine mesylate as an antiparkinson agent in order to evaluate the development of extrapyramidal symptoms that could be occurred when an antiparkinson drug was stopped. The authors observed the development of extrapyramidal symptoms after the withdrawal of benztropine mesylate for 6 weeks. Brief Psychiatric Rating Scale and Rating Scale for Extrapyramidal Symptoms was used for the assessment of psychotic symptoms and extrapyramidal symptoms respectively. The results were as follows ； 1) Of the 161 subjects, 105 patients(65.2%) developed extrapyramidal symptoms necessitating the antiparkinson agent. 2) Daily mean dose of benztropine in symptomatic group was much more than in asymptomatic group(t = 2.52，df = 159，p 〈 0.05). 3) I n the development of EPS, perphenazine(x2 = 4.5, df = 1, p < 0.05) and haloperidol(x2 = 24.5, d f= 1, p < 0 .0 0 1 ) was used more frequently in symptomatic group than in asymptomatic group, but chlorpromazine was not significantly different between two groups(x2 = 2.6, d f = 1, p < 0.05). 4) Mean Scores of BPRS at the manifestation of extrapyramidal symptoms were higher in symptomatic group than in asymptomatic group(t = 6.39，d f = 159，p 〈 0.001). 5) In symptomatic group, 81.9% of subjects developed extrapyramidal symptoms within the third week and those developments commonly occured from 9 o’clock a.m. to 3 o’clock p.m. and from 6 o oclock p.m. to 9 o’oclock p.m. in a 24 hour period. Our data suggest that we should prescribe the antipsychotic medication with antiparkinson agent carefully. Also we can anticipate more frequent extrapyramidal symptoms in relatively high potency antipsychotic medication. Our data recommends that it is better to prescribe the antiparkinson agent at a low dose, single morning dose due to frequent developments of extrapyramidal symptoms during the day