Ames D, Wirshing W C, Szuba M P
Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles School of Medicine.
J Clin Psychiatry. 1992 Feb;53(2):53-5.
Bupropion hydrochloride is a phenylaminoketone antidepressant whose clinical pharmacology is poorly understood. Part of bupropion's action may be attributed to inhibition of dopamine reuptake that may induce organic mental disorders in certain susceptible patients. We report three cases of organic mental disorders in patients receiving bupropion hydrochloride for treatment of the depressed phase of their bipolar-type mood instability. The organic mental disorders that occurred in these patients were characterized largely by visual disturbances--visual hallucinations and visual illusions--although one patient also experienced auditory hallucinations. The patients' use of concomitant medications and potential drug interactions are carefully evaluated and the literature on bupropion's ability to induce organic mental disorders is reviewed. We suggest a number of possible mediating mechanisms for these syndromes including dose-related dopaminergic augmentation, accumulation of toxic metabolites, predisposition to psychosis, and drug interactions.
盐酸安非他酮是一种苯基氨基酮类抗抑郁药，其临床药理学尚未被充分了解。安非他酮的部分作用可能归因于对多巴胺再摄取的抑制，这可能在某些易感患者中诱发器质性精神障碍。我们报告了3例接受盐酸安非他酮治疗双相型情绪不稳定抑郁期的患者发生器质性精神障碍的病例。这些患者发生的器质性精神障碍主要表现为视觉障碍——视幻觉和视错觉——尽管有1例患者还出现了听幻觉。我们仔细评估了患者同时使用的药物及其潜在的药物相互作用，并回顾了有关安非他酮诱发器质性精神障碍能力的文献。我们提出了这些综合征的一些可能的介导机制，包括剂量相关的多巴胺能增强、有毒代谢产物的积累、易患精神病以及药物相互作用。
