A 45-year-old man who has received long-term treatment for schizophrenia recently has been displaying involuntary facial movements that include lateral deviations of the jaw and “fly catching” motions of the tongue. Which of the following agents is the most likely cause of his involuntary movements?
一名长期接受精神分裂症治疗的45岁男性最近出现了不自主的面部运动,包括下颌侧向偏移和舌头的“抓苍蝇”动作。下列哪一种因素最有可能引起他的不自主运动?
(A) Clozapine 氯氮平
(B) Fluphenazine 氟吩嗪
(C) Lithium 锂
(D) Selegiline 司立吉林
(E) Ziprasidone 齐拉西酮
答案解析:
该患者表现出迟发性运动障碍的体征,这是长期使用抗精神病药的并发症,被认为是抗精神病药对长期受体阻滞产生反应,导致多巴胺雷杰普多合成增加的结果。如该患者所见的异常动作,如舌伸舌和颌脱垂,是多巴胺相对过量影响运动通路的结果。这种并发症在使用较老的、典型的抗精神病药物如氟吩嗪和氟哌啶醇时更为常见。
正确答案:B
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