Lee Jimmy, Teoh Timothy, Lee Tih-Shih
Department of Psychiatry, Singapore General Hospital, Singapore.
J Psychosom Res. 2008 Jan;64(1):107-9. doi: 10.1016/j.jpsychores.2007.05.014. Epub 2007 Aug 1.
Sibutramine is a serotonin and norepinephrine reuptake intake inhibitor approved for the management of obesity. It has various CNS adverse effects and a few case reports of psychiatric manifestations. Here, we report a case of severe catatonic and psychotic symptoms associated with sibutramine overuse in the patient who had no prior psychiatric history. The symptoms subsequently resolved completely with cessation. Given the widespread use of sibutramine, this case would be of interest to practitioners of internal medicine and psychiatry. Moreover, as sibutramine may be used for weight management in patients on antipsychotic medications, the implications on psychotic symptoms need to be explored further. We also discuss possible pathophysiologic underpinnings.
西布曲明是一种被批准用于治疗肥胖症的5-羟色胺和去甲肾上腺素再摄取抑制剂。它有多种中枢神经系统不良反应，并有一些关于精神症状的病例报告。在此，我们报告一例在无既往精神病史的患者中因过量使用西布曲明而出现严重紧张症和精神病症状的病例。症状随后在停药后完全缓解。鉴于西布曲明的广泛使用，内科和精神科医生可能会对该病例感兴趣。此外，由于西布曲明可用于抗精神病药物治疗的患者的体重管理，其对精神病症状的影响需要进一步探讨。我们还讨论了可能的病理生理基础。
