Gladston S, Clarke D J
Heath Lane Hospital, Heath Lane, West Bromwich, UK.
J Intellect Disabil Res. 2005 Jul;49(Pt 7):567-70. doi: 10.1111/j.1365-2788.2005.00708.x.
Clozapine is licensed for the treatment of psychotic illnesses resistant to other antipsychotic medications. Velo-cardio-facial syndrome (VCFS) is associated with a vulnerability to psychotic illness that may be resistant to treatment with conventional typical and atypical antipsychotics.
A 32-year-old man with intellectual disability (ID) and a long history of treatment-resistant psychosis was found to have VCFS. Treatment with typical antipsychotic drugs and with one atypical olanzapine produced no improvement.
Treatment with clozapine produced an improvement in psychotic symptoms and associated behavioural abnormalities, but caused hypersalivation, constipation and a seizure disorder. The latter led to two fractures, one requiring surgery. The addition of sodium valproate stopped seizures.
Clozapine may improve psychotic symptoms for people with ID associated with VCFS, but clinicians should be alert for potential adverse effects.
氯氮平被批准用于治疗对其他抗精神病药物耐药的精神病性疾病。心面综合征（VCFS）与对精神病性疾病的易感性有关，这种疾病可能对传统的典型和非典型抗精神病药物治疗耐药。
一名32岁的智障男性，有长期难治性精神病病史，被发现患有VCFS。使用典型抗精神病药物和一种非典型药物奥氮平治疗均无改善。
氯氮平治疗使精神病症状及相关行为异常有所改善，但导致了流涎过多、便秘和癫痫发作障碍。后者导致两处骨折，其中一处需要手术。加用丙戊酸钠后癫痫发作停止。
氯氮平可能改善与VCFS相关的智障患者的精神病症状，但临床医生应警惕潜在的不良反应。
