利培酮治疗的精神分裂症患者抑郁缓解后体重过度增加：病例报告
Excessive weight gain after remission of depression in a schizophrenic patient treated with risperidone: case report.
作者信息
Theleritis Christos G, Papadimitriou George N, Papageorgiou Charalabos C, Dikeos Dimitris G, Masdrakis Vasilis, Kostoulas Constantin, Psarros Constantin, Soldatos Constantin R
机构信息
Department of Psychiatry, Athens University Medical School, Eginition Hospital, Athens, Greece.
出版信息
BMC Psychiatry. 2006 Sep 5;6:37. doi: 10.1186/1471-244X-6-37.
BACKGROUND
The use of atypical antipsychotics in schizophrenic patients has been associated with a risk of weight gain. Similarly, recovery from depression is often followed by improved appetite, greater food intake and potential increase in weight.
CASE PRESENTATION
A Caucasian 33-year-old schizophrenic female patient was being treated with 6 mg/day of risperidone and 15 mg/day of clorazepate. She developed depressive symptomatology and 40 mg/day of fluoxetine was gradually added to her treatment regimen for about 9 months. After the remission of depression, and the discontinuation of fluoxetine, she experienced an increase in appetite and subsequently excessive weight gain of 52 kg. Re-administration of fluoxetine did not reverse the situation. The patient developed diabetes mellitus, which was successfully controlled with metformin 1700 mg/day. The addition at first of orlistat 360 mg/day and later of topiramate 200 mg/day has helped her to lose a significant part of the weight gained (30 kg).
CONCLUSION
The case suggests a probable association between the remission of depressive symptomatology and weight gain in a schizophrenic patient.
背景
在精神分裂症患者中使用非典型抗精神病药物与体重增加风险相关。同样，抑郁症康复后通常会出现食欲改善、食物摄入量增加以及体重可能增加的情况。
病例介绍
一名33岁的白种人女性精神分裂症患者，正在接受每日6毫克利培酮和每日15毫克氯氮䓬的治疗。她出现了抑郁症状，在其治疗方案中逐渐添加了每日40毫克氟西汀，持续约9个月。抑郁症缓解且停用氟西汀后，她食欲增加，随后体重过度增加了52千克。重新服用氟西汀并未扭转这种情况。该患者患上了糖尿病，通过每日1700毫克二甲双胍成功控制。最初添加每日360毫克奥利司他，后来添加每日200毫克托吡酯，帮助她减掉了很大一部分增加的体重（30千克）。
结论
该病例表明，精神分裂症患者抑郁症状的缓解与体重增加之间可能存在关联。
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