Mishra Achal, Moore P Brian, Hobbs Rosemary
Mental Health Unit, Leazes Wing, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.
J Psychopharmacol. 2004 Jun;18(2):281-4. doi: 10.1177/0269881104042635.
We present a series of three cases who developed manic symptoms on introduction of quetiapine to their medication regime. All were male, with long-standing psychotic illnesses (schizophrenia/schizoaffective disorder), relatively well maintained on medication until their deterioration which prompted a review of their medication. The dose range of prescribed quetiapine was 300-800 mg daily. Two patients had previously received antidepressants without displaying manic symptoms. The mania subsided on withdrawal of quetiapine in two patients. The third patient continued on quetiapine but with the addition of zuclopenthixol depot. Sodium valproate was prescribed to the other two patients, and quetiapine was discontinued. These cases indicate that a side-effect of quetiapine may be mood elevation. An ability to elevate mood while controlling psychoses would be helpful in the treatment of post-psychotic and bipolar depression. Its clinical importance in the control of manic episodes, for which atypical antipsychotics are used increasingly, is uncertain.
我们报告了3例在将喹硫平纳入其药物治疗方案后出现躁狂症状的病例。所有患者均为男性，患有长期精神病性疾病（精神分裂症/分裂情感性障碍），在病情恶化促使对其药物治疗进行审查之前，病情相对稳定。喹硫平的处方剂量范围为每日300 - 800毫克。两名患者此前曾服用抗抑郁药但未出现躁狂症状。两名患者停用喹硫平后躁狂症状消退。第三名患者继续服用喹硫平，但加用了长效珠氯噻醇。另外两名患者服用了丙戊酸钠，停用了喹硫平。这些病例表明，喹硫平的副作用可能是情绪高涨。在控制精神病的同时提高情绪的能力，将有助于治疗精神病后抑郁和双相抑郁。其在控制越来越多地使用非典型抗精神病药物治疗的躁狂发作中的临床重要性尚不确定。
