Yueh Che-Lin, Yu Sung-Lin, Chen Hsiao-Min, Wu Bo-Jian, Chen Wen-Ching
Yuli Hospital, Department of Health, No. 448, Chaung-Hua Road, Yuli, Hualien, 98141, Taiwan.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.03.2009.1693. Epub 2009 Jul 14.
Aripiprazole has been recognised as a third generation antipsychotic and is considered to be distinguished from typical and atypical antipsychotics. In clinical trials, researchers did not mention the risk of aripiprazole-induced seizure, but during a literature review a case report was found that discussed this potential side effect. The present report concerns a 54-year-old man with chronic schizophrenia who developed a witnessed grand mal seizure after he had abruptly discontinued clozapine and benzodiazepam (BZD) treatment and concurrently reinitiated aripiprazole treatment as the result of an involuntary clinical error. The possible causes were explored, including clozapine-induced or withdrawal seizure, BZD withdrawal syndrome, psychogenic non-epileptic seizure, hyponatraemia, brain tumour and major physical illness, but none of the hypotheses can explain the seizure observed in this case. This second case is presented to corroborate a previous finding and emphasise the possibility of aripiprazole-induced seizure.
阿立哌唑已被公认为第三代抗精神病药物，被认为有别于典型和非典型抗精神病药物。在临床试验中，研究人员未提及阿立哌唑诱发癫痫发作的风险，但在文献回顾过程中发现了一篇病例报告讨论了这种潜在的副作用。本报告涉及一名54岁的慢性精神分裂症男性患者，由于一次非自愿的临床失误，他突然停用氯氮平和苯二氮䓬（BZD）治疗，同时重新开始使用阿立哌唑治疗后，出现了一次有目击者见证的癫痫大发作。对可能的病因进行了探究，包括氯氮平诱发或戒断性癫痫发作、BZD戒断综合征、心因性非癫痫性发作、低钠血症、脑肿瘤和重大躯体疾病，但这些假设均无法解释该病例中观察到的癫痫发作。现呈现这第二例病例以确证先前的发现，并强调阿立哌唑诱发癫痫发作的可能性。
