Kodama Rieko, Morita Shuhei, Miwa Hideto, Kondo Tomoyoshi
Department of Neurology, Wakayama Medical University, 811-1 Kimiidera, Wakayama-City, Wakayama 641-8510, Japan.
No To Shinkei. 2003 May;55(5):413-7.
Psychosis characterized by hallucination or delusion, which occurs during drug therapy of parkinsonian patients, is one of the limiting factors for the control of motor symptoms or complications. In the present study, we encountered three patients with Parkinson's disease (PD) at advanced stages; all three patients had severe psychosis and severe wearing-off phenomenon and one had severe orthostatic hypotension. Their psychotic symptoms were successfully treated by administration of quetiapine, resulting in the favorable control of motor fluctuations and elevation of therapeutic levels unless any aggravation of parkinsonism occurs. Although the measure against drug-induced psychosis is principally a reduction of the doses or withdrawal of causative drugs, the effective use of antipsychotic drugs, such as quetiapine, is helpful to suppress psychosis and allow the patient to adjust to antiparkinsonian drugs for the control of symptoms other than psychosis.
以幻觉或妄想为特征的精神病，发生在帕金森病患者的药物治疗期间，是控制运动症状或并发症的限制因素之一。在本研究中，我们遇到了三名晚期帕金森病（PD）患者；所有三名患者都有严重的精神病和严重的疗效减退现象，其中一名患者有严重的直立性低血压。通过给予喹硫平成功治疗了他们的精神病症状，除非帕金森病加重，否则可有效控制运动波动并提高治疗水平。虽然针对药物性精神病的措施主要是减少剂量或停用致病药物，但有效使用抗精神病药物，如喹硫平，有助于抑制精神病，并使患者能够适应抗帕金森病药物以控制除精神病以外的症状。
