Laux G, Gunreben G
Psychiatrische Universitätsklinik Würzburg.
Dtsch Med Wochenschr. 1991 Jun 21;116(25):977-80. doi: 10.1055/s-2008-1063706.
Shooting, tonic cramps of the neck muscles with jolt-like contractions in the mouth and jaw regions and propulsive movements of both arms developed in a 25-year-old woman who, over a period of six months, had been given nine intramuscular injections of the depot neuroleptic fluspirilene, 1.5 mg each, because of apathy and depression. Treatment with biperiden (up to 20 mg daily) and benzodiazepines was unsuccessful, while tiapride (up to 1000 mg daily) brought about slight improvement and 15 mg haloperidol achieved complete remission. However, distinct parkinsonian features developed. Slow gradual reduction of the haloperidol dose again led to extrapyramidal motor symptoms, even when tiapride or bromocriptine was given as well. After six months' administration of clozapine, up to 500 mg daily, and gradual dose reduction all symptoms fully regressed. This case demonstrates that the risk of extrapyramidal motor abnormalities from "neuroleptic anxiolysis" should not be underestimated.
一名25岁女性出现了颈部肌肉的强直性痉挛，伴有口颌部的震颤样收缩以及双臂的推进性运动。该女性因淡漠和抑郁，在六个月内接受了九次长效抗精神病药物氟司必林的肌肉注射，每次1.5毫克。使用安坦（每日剂量高达20毫克）和苯二氮䓬类药物治疗均未成功，而硫必利（每日剂量高达1000毫克）带来了轻微改善，15毫克氟哌啶醇实现了完全缓解。然而，出现了明显的帕金森氏症特征。即使同时给予硫必利或溴隐亭，逐渐缓慢减少氟哌啶醇剂量仍再次导致锥体外系运动症状。在每日服用高达500毫克氯氮平六个月并逐渐减量后，所有症状完全消退。该病例表明，“抗精神病药物抗焦虑治疗”导致锥体外系运动异常的风险不应被低估。
