P. Castrogiovanni, S. Iapichino, F. Pieraccini - Vol. 6, Settembre 2000, num.3
Testo Immagini Bibliografia Summary Riassunto Indice
Neurolettici tradizionali e nuovi
antipsicotici nella relazione terapeutica
Typical and atypical antipsychotic drugs in therapist-patient relationship
Beneficial effects on psychotic symptoms have been reported with typical neuroleptics, but both clinical trials and practice suggest that these drugs induce severe neurological (i.e., akathisia, parkinsonism) and nonneurological side effects (orthostatic hypotension, sedation, hyperprolactinaemia). Akinesia and akathisia appear to be the most commonly reported side effects related to noncompliance. In addition to their motor and neurological symptoms, neuroleptics have been associated with cognitive dysfunction, particularly in long-term treatment. The adverse neurocognitive effects reduce patient's ability and motivation to partecipate in treatment and rehabilitation. Furthermore, typical neuroleptic agents appear not to be effective in the "negative syndrome" of schizophrenia. Drug research obtained new antipsychotic drugs with mechanisms of action different from those of typical agents (dopamine transmission is not the only pathogenic mechanism of schizophrenia), which have lower neurological and cognitive side effects. This paper examines the impact of new antipsychotic drugs, as compared to typical neuroleptics, on compliance of schizophrenic subjects and the patient-therapist relationship.