Kim Sung-Wan, Shin Il-Seon, Kim Jae-Min, Lim So-Yeon, Yang Su-Jin, Yoon Jin-Sang
Department of Psychiatry, Chonnam National University Medical School, Repiblic of Korea.
Clin Neuropharmacol. 2005 Sep-Oct;28(5):249-51. doi: 10.1097/01.wnf.0000185825.34819.ba.
Selective serotonin reuptake inhibitors (SSRIs) have been recognized as the treatment of choice for pathological laughing and crying (PLC), which is a common, distressing condition that follows stroke. There have been few reports about other treatment options for PLC. Here, the authors report rapid responses to mirtazapine in two patients with poststroke PLC who failed to respond to SSRIs or bupropion. In the first case, a 63-year-old woman with severe long-standing crying spells that had persisted for 3 months responded well to low-dose mirtazapine within a few days; she could not tolerate citalopram or sertraline. In the second case, both the laughing and crying spells of a 64-year-old woman were improved within a few days of mirtazapine administration, after they had not responded to bupropion. This is one of the first reports to suggest that mirtazapine may be an alternative to SSRIs for treating poststroke PLC.
选择性5-羟色胺再摄取抑制剂（SSRIs）已被公认为是治疗病理性哭笑（PLC）的首选药物，病理性哭笑是中风后常见且令人痛苦的病症。关于PLC的其他治疗选择，报道较少。在此，作者报告了两例中风后PLC患者对米氮平迅速产生反应，这两名患者对SSRIs或安非他酮均无反应。在第一个病例中，一名63岁的女性长期存在严重的哭泣发作，持续了3个月，在几天内对低剂量米氮平反应良好；她无法耐受西酞普兰或舍曲林。在第二个病例中，一名64岁女性的哭笑发作在服用米氮平几天后得到改善，此前她对安非他酮无反应。这是首批表明米氮平可能是治疗中风后PLC替代SSRIs的报告之一。
