Zesiewicz Theresa A, Borra Sujatha, Hauser Robert A
Department of Neurology, Parkinson's Disease and Movement Disorders Center, University of South Florida and Tampa General Healthcare, Tampa, Florida 33606, USA.
Mov Disord. 2002 Nov;17(6):1365-7. doi: 10.1002/mds.10282.
Abrupt clozapine withdrawal can cause rebound psychosis and severe somatic symptoms in psychiatric patients. We report on the case of an advanced Parkinson's disease patient who developed myoclonus, tremor, rigidity, hyperreflexia, and stupor after abrupt clozapine withdrawal. The patient's symptoms resolved with treatment with cyproheptadine. This clinical picture suggests serotonergic rebound as an explanation for the patient's symptoms, although other pharmacological mechanisms are possible. Clozapine should be gradually withdrawn over a period of 1 to 2 weeks when possible, and abruptly discontinued only when necessary.
突然停用氯氮平可导致精神病患者出现反弹性精神病和严重的躯体症状。我们报告一例晚期帕金森病患者，在突然停用氯氮平后出现肌阵挛、震颤、强直、反射亢进和木僵。患者的症状经赛庚啶治疗后缓解。尽管可能存在其他药理机制，但这种临床情况提示血清素能反跳可解释患者的症状。氯氮平应尽可能在1至2周内逐渐停药，仅在必要时才突然停药。
