Tahiroglu Aysegul Yolga, Avci Ayse
Department of Child and Adolescent Psychiatry, Cukurova University Medical Faculty, Turkey.
Psychopharmacol Bull. 2007;40(2):129-33.
Extrapyramidal symptoms (EPSs) (dystonic reaction, rigidity, and akathisia) occur as a result of D2 receptor blockade. Selective serotonin-reuptake inhibitors (SSRIs) have been reported to induce extrapyramidal signs and symptoms but tricyclic antidepressants have been rarely reported. Among the side effects attributed to valproic acid administration, the production of EPS is very rare, particularly in children. In this paper we present a case (10-year-old girl) under multiple pharmacologic treatment who developed EPSs (oculogyric crisis) shortly after the adjunct of imipramine to a combination of methylphenidate and valproic acid. Oculogyric crisis occurred on the third day of this combination treatment and these symptoms included ocular pain and sustained upward gaze. Benztropine 2 mg i.m. resulted in rapid relief of oculogyric crisis symptoms.
锥体外系症状（EPSs）（肌张力障碍反应、强直和静坐不能）是由于D2受体阻断所致。据报道，选择性5-羟色胺再摄取抑制剂（SSRIs）可诱发锥体外系体征和症状，但三环类抗抑郁药很少有此类报道。在丙戊酸给药的副作用中，EPS的发生非常罕见，尤其是在儿童中。本文报告一例（一名10岁女孩）接受多种药物治疗的病例，在将丙咪嗪添加到哌甲酯和丙戊酸联合用药后不久出现了EPSs（动眼危象）。动眼危象发生在联合治疗的第三天，这些症状包括眼痛和持续向上凝视。肌肉注射2mg苯海索可迅速缓解动眼危象症状。
