Abstract:
Acute laryngeal dystonia (ALD) is a rare but potentially life-threatening complication of both first-generation (FGA) and second-generation (SGA) antipsychotic medication. Delays in diagnosis and treatment have been associated with mortality. We carried out a systematic review of antipsychotic-induced acute laryngeal dystonia using the databases Ovid MEDLINE, PubMed, CINAHL, and EMBASE. Search terms included: (antipsychotic* OR antipsychotic-induced OR neuroleptic* OR neuroleptic-induced) AND (laryngeal dystonia* OR laryngo-pharyngeal dystonia* OR laryngospasm OR laryngeal spasm OR dystonic reaction* OR extrapyramidal reaction*) where * specified plural forms of the relevant word. Forty articles (describing 45 cases) met eligibility criteria. ALD occurred with both first- and second- generation antipsychotics but was more commonly reported in FGAs. ALD occurred in association with low, moderate and high doses (within the usual dose ranges of both high and low potency agents). Young males appeared to be most at risk of antipsychotic-induced ALD, especially those treated with high potency agents. Anticholinergic medication (including antihistamines with anticholinergic properties) usually provided rapid and effective relief, especially if administered parentally. Vigilance is indicated for idiosyncratic ALD emergence when initiating, or increasing the dose of, an antipsychotic medication. Rapid treatment with an anticholinergic medication is recommended to prevent adverse outcomes.
摘要:
急性喉肌张力障碍(ALD)是第一代(FGA)和第二代(SGA)抗精神病药物的罕见但可能危及生命的并发症。诊断和治疗的延迟与死亡率相关。我们使用OvidMEDLINE数据库对抗精神病药物引起的急性喉肌张力障碍进行了系统评价,PubMed,CINAHL,和EMBASE。搜索术语包括:(抗精神病药*或抗精神病药引起的或抗精神病药*或抗精神病药*或抗精神病药引起的)和(喉肌张力障碍*或喉咽肌张力障碍*或喉痉挛或肌张力障碍反应*或锥体外系反应*)其中*指定了相关单词的复数形式。40篇文章(描述45个案例)符合资格标准。ALD发生在第一代和第二代抗精神病药物中,但在FGA中更常见。ALD发生与低,中等和高剂量(在高和低效力药物的通常剂量范围内)。年轻男性似乎最容易患上抗精神病药物引起的ALD,特别是那些用高效药物治疗的。抗胆碱能药物(包括具有抗胆碱能特性的抗组胺药)通常提供快速有效的缓解,尤其是用父母的方式管理。启动时,对于特殊的ALD出现表示警惕,或者增加剂量,抗精神病药物.建议使用抗胆碱能药物进行快速治疗以防止不良后果。