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[非典型抗精神病药物中毒——弗罗茨瓦夫急性中毒科的数据]

[Intoxications with atypical antipsychotic drugs--data of the Acute Intoxication Unit in Wrocław].

作者信息

Magdalan Jan, Wasyko-Smolarek Małgorzata, Antończyk Andrzej, Kochman Krystyna, Przewłocki Michał, Porebska Barbara

机构信息

Oddział Ostrych Zatruć, Dolnoślaskiego Szpitala Specjalistycznego im. T. Marciniaka, Centrum Medycyny Ratunkowej we Wrocławiu.

出版信息

Przegl Lek. 2004;61(4):392-6.

Abstract

Recently, atypical antipsychotic agents have largely replaced traditional agents as first-line drugs for the treatment of schizophrenia and psychotic mood disorders. Considering the increase in atypical antipsychotics prescriptions and the increased risk of suicide in this patient population, the number of reported cases of antipsychotic drugs may be expected to increase. This paper describes the clinical course of atypical antipsychotic agents intoxication, chiefly clozapine, risperidone and olanzapine. Clozapine was the ingestant in 11 cases of atypical antipsychotics overdose in our material. The major observed effects in this group included deep coma, tachycardia, hypersalivation, delirium and shock. Clozapine has a small therapeutic index; in our patients the mortality rate was 27%. Ten patients with risperidone overdose were identified. Our data show that risperidone toxicity manifests mainly as mild central nervous system effects: somnolence, vertigo and tardive dyskinesia. Olanzapine has been considered to be similar to clozapine, but olanzapine intoxication appeared to have a relatively benign clinical course as compared with clozapine intoxication. In olanzapine intoxications deep coma, myosis and mild cardiovascular effects (hypotonia) were observed.

摘要

近年来,非典型抗精神病药物已在很大程度上取代传统药物,成为治疗精神分裂症和伴有精神病性症状的心境障碍的一线用药。鉴于非典型抗精神病药物处方量的增加以及该患者群体自杀风险的上升,抗精神病药物中毒的报告病例数可能会增加。本文描述了非典型抗精神病药物中毒的临床过程,主要涉及氯氮平、利培酮和奥氮平。在我们收集的资料中,11例非典型抗精神病药物过量中毒病例的摄入药物为氯氮平。该组观察到的主要效应包括深度昏迷、心动过速、流涎过多、谵妄和休克。氯氮平的治疗指数较小;在我们的患者中,死亡率为27%。确定了10例利培酮过量中毒患者。我们的数据表明,利培酮中毒主要表现为轻度中枢神经系统效应:嗜睡、眩晕和迟发性运动障碍。奥氮平曾被认为与氯氮平相似,但与氯氮平中毒相比,奥氮平中毒似乎具有相对良性的临床过程。在奥氮平中毒病例中,观察到深度昏迷、瞳孔缩小和轻度心血管效应(肌张力减退)。

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