정신분열증 환자에 있어 항정신병 약물의 치료 용량에 대한 임상적 지표로서의 추체외로 징후에 대한 연구

Neuroleptic-induced Extrapyramidal Signs as a Clinical Marker for Therapeutic dose of Antipsychotics in Schizophrenics

This study was performed to investigate whether the neuroleptic induced extrapyramidal signs could be a clinical maker for therapeutic dose of antipsychotics in schizophrenics. In 30 schizophrenics who had not taken drugs for more than 2 weeks, haloperidol was administered according to drug increasing schedule, and m inor and m ajor extrapyramidal signs were evaluated by Operational Criteria of Neuroleptic Threshold, Dimascio’ s EPS criteria, and Simpson’ s EPS criteria. If extrapyramidal signs appeared, the dosage of haloperidol was fixed at that level. Changes of symptoms were evaluated by BPRS at 5 days intervals. The results were as follows ： 1) Daily mean haloperidol dose of Non-EPS group was 10.93± O.OOmg, and this was significantly higher than 6.81±2.45mg of Minor EPS group, or 5.67±3.13mg of Major EPS group. 2) Mean total scores of BPRS and three subscales(anxiety-depression, thought disturbance and hostility-suspiciousness) were not different am ong three groups. 3) Mean percent improvement of BPRS total scores in Non-EPS, Minor EPS, and Major EPS groups were 47.4%, 41.3% and 48.0 %, respectively. For each group, improvement of BPRS total scores was significant, but there was no difference among three groups. These findings suggest that the neuroleptic-induced EPSs are not necessary response to antipsychotics absolutely. But EPSs may be a clinical marker for therapeutic dose of antipsychotics in schizophrenics.