Abe Kazuhiko
Faculty of Health and Welfare, Seinan Jogakuin University, Kitakyushu, Japan.
World J Biol Psychiatry. 2006;7(2):70-4. doi: 10.1080/15622970500222443.
Antipsychotics have been found to induce recurrent psychotic episodes lasting minutes to hours, mostly accompanied by oculogyric crisis (OGC). To characterize this side effect, antipsychotic-induced and postencephalitic OGCs that were reported in the literature were compared to find out common characteristics of OGCs and their associated symptoms. Both postencephalitic and antipsychotic-induced OGCs were found to occur late in the day and at regular intervals, and were associated with autonomic symptoms such as profuse sweating, facial flushing, transitory hypertension and difficulty in micturition. They were often associated also with transient psychiatric episodes: visual hallucinations and illusions, auditory hallucinations, delusions, catatonic phenomena, obsessive thoughts and panic attacks. These (OGC) characteristics will be useful in recognizing antipsychotic-induced psychiatric episodes. The associated psychiatric episodes were noted to recur occasionally also without OGC in a few postencephalic cases, and during gradual dose reduction or after a switch to a novel or low-potency antipsychotic in drug-induced cases. These findings suggest that episodes with the OGC characteristics but without OGC per se, may be less severe reactions to antipsychotic medication than those with OGC, and may represent manifestations of subclinical OGC.
已发现抗精神病药物可诱发持续数分钟至数小时的反复性精神病发作,大多伴有动眼危象(OGC)。为了描述这种副作用,对文献中报道的抗精神病药物诱发的OGC和脑炎后OGC进行了比较,以找出OGC及其相关症状的共同特征。结果发现,脑炎后和抗精神病药物诱发的OGC均在一天中的晚些时候且有规律地发生,并伴有自主神经症状,如大量出汗、面部潮红、短暂性高血压和排尿困难。它们还常常伴有短暂的精神症状:视幻觉和错觉、听幻觉、妄想、紧张症现象、强迫观念和惊恐发作。这些(OGC)特征将有助于识别抗精神病药物诱发的精神发作。在少数脑炎后病例中,相关的精神发作在没有OGC的情况下也偶尔会复发,在药物诱发的病例中,在逐渐减少剂量或换用新型或低效价抗精神病药物期间也会出现这种情况。这些发现表明,具有OGC特征但本身无OGC的发作,可能是对抗精神病药物治疗的较轻微反应,可能代表亚临床OGC的表现。