Department of Psychiatry, Father Muller Medical College, Mangalore - 575 002, India.
Indian J Psychiatry. 2009 Oct-Dec;51(4):308-9. doi: 10.4103/0019-5545.58301.
Venlafaxine, an antidepressant belongs to Serotonin Norepinephrine Reuptake Inhibitors (SNRI), blocks the synaptic reuptake of serotonin in lower doses and also blocks reuptake of norepinephrine in higher doses. In addition it also blocks dopamine reuptake in still higher doses. This last mechanism of action is found to cause psychotic symptoms. Very few cases are reported with this adverse effect of venlafaxine. Here is a case report where a 32 year-old male with social phobia developed delusions of persecution on two occasions when he was put on venlafaxine 150 mg/day, which responded to withdrawal of venlafaxine and a short course of antipsychotics. The delusions never reappeared when he was maintained on escitalopram.
文拉法辛，一种抗抑郁药，属于血清素去甲肾上腺素再摄取抑制剂（SNRI），低剂量时阻断血清素的突触再摄取，高剂量时也阻断去甲肾上腺素的再摄取。此外，它还在更高的剂量下阻断多巴胺的再摄取。这种最后一种作用机制被发现会导致精神病症状。文拉法辛很少有这种不良反应的报告。这里报告了一例病例，一名 32 岁的男性社交恐惧症患者，在服用文拉法辛 150 毫克/天的两次时出现被害妄想，当他停止服用文拉法辛并服用短期抗精神病药物时，妄想得到缓解。当他服用依他普仑时，妄想从未再次出现。
