Author/Editor		Dernovšek, Mojca Z; Tavčar, Rok; Darovec, Jože
Title		Anketa o zdravljenju ekstrapiramidnih stranskih učinkov antipsihotikov
Translated title		Survey of treating extrapyramidal side effects of antipsychotic drugs
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 66, št. 1
Publication year		1997
Volume		str. 11-3
Language		slo
Abstract		Background. Antipsychotics (neuroleptics) often cause extrapyramidal side effects (EPSE). The aim of this study was to assess the current practice of diagnosing and treating EPSE of antipsychotics. Methods. A questionnaire was sent to 160 Slovene psychiatrists. Chy-square tests and analyses of variance with Fisher's test were used for statistical analyses. Results. Seventy-two psychiatrists (45%) returned the questionnaire. One third of them frequently (and one half occasionally) encounter patients with EPSE. The psychiatrists most often diagnose EPSE with clinical examination. The most treatment-resistant EPSE is for one half of psychiatrists tardive dyskinesia and for one third of them tardive dystonia, drug-induced parkinsonism and akathisia. They usually treat acute dystonia with anticholinergic antiparkinsonics (ACAP). For treatment of akathisia the psychiatrists most often reduce the doses of classic antipsychotics or add ACAP. In case of tardive dyskinesia/dystonia, most psychiatrists change classic antipsychotic for an atypical one. One half of psychiatrists consider the current practice of prescribing ACAP as appropriate, but two-thirds of them state that ACAP are prescribed too often. Most of them often try to discontinue prescribing of ACAP. Almost all psychiatrists prefer biperiden as the first choice among ACAP and only one tenth of them prescribe also trihexifenidil. The most often used benzoadiazepine is diazepam and among beta blockers propranolol is most often prescribed. Conclusions. The assessed practice of diagnosing and treating EPSE is congruent with guidelines in the current literature.
Summary		Izhodišča. Antipsihotiki (nevroleptiki) pogosto povzročajo ekstrapiramidne stranske učinke (EPSU). Z anketo so avtorji želeli ugotoviti mnenja psihiatrov glede spoznavanja in zdravljenja EPSU. Metode. Stošestdesetim slovenskim psihiatrom so poslali vprašalnik o spoznavanju in zdravljenju EPSU antipsihotikov. Rezultati. Prejeli so 72 odgovorov (45%). Z EPSU se pogosto sreča tretjina psihiatrov, občasno pa polovica. Stranske učinke antipsihotikov večinoma ugotavljajo s kliničnim pregledom in z navedbami bolnika. Kot najtežje terapevtsko obvladljivo motnjo je več kot polovica psihiatrov navedla tardivno diskinezijo, priblično tretjina pa še tardivno distonijo, akatizijo in medikamentni parkinsonizem. Pri zdravljenju akutne distonije psihiatri največkrat izberejo antiholinergični antiparkinsonik (AHAP). Akatizijo in medikamentni parkinsonizem večinoma zdravijo z zmanjšanjem odmerka predpisanega klasičnega antipsihotika ali z AHAP. Pri tardivni diskineziji ali tardivni distoniji psihiatri največkrat zamenjajo klasični antipsihotik z atipičnim. Skoraj polovici anketiranih psihiatrov se zdi trenutna praksa predpisovanja AHAP jasna. Dve tretjini anketiranih menita, da AHAP prepogosto predpisujemo. Večina pogosto poskuša ukinjati jemanje AHAP. V ambulanti in bolnišnici zdravniki skoraj izključno uporabljajo biperiden, le desetina pa tudi triheksifenidil. Od benzodiazepinov uporabljajo največ diazepam, od beta blokatorjev pa večina pripranolol. Zaključki. Ukrepanje pri EPSU antipsihotikov je ustrezno smernicam v literaturi.
Descriptors		ANTIPSYCHOTIC AGENTS AKATHISIA, DRUG-INDUCED DYSTONIA DYSKINESIA, DRUG-INDUCED PARKINSON DISEASE, POSTENCEPHALITIC QUESTIONNAIRES ANTIPARKINSON AGENTS BENZODIAZEPINES ADRENERGIC BETA-ANTAGONISTS