与氯氮平联合电休克治疗相关的延迟发作、持续性谵妄和吸入性肺炎。
Delayed onset, protracted delirium and aspiration pneumonitis associated with a combination of clozapine and electroconvulsive therapy.
作者信息
Manjunatha N, Ram Kumar G S, Vidyendaran R, Muralidharan K, John J P
机构信息
Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India.
出版信息
Indian J Psychol Med. 2011 Jan;33(1):80-2. doi: 10.4103/0253-7176.85402.
Abstract
Few studies reported the efficacy and safety in combination of clozapine and electroconvulsive therapy (ECT) in schizophrenia; systematic studies are lacking. Side effects like seizure, and confusional state are reported. Authors report two cases of delayed onset/protracted delirium with ECT and clozapine in schizophrenia, one of whom developed aspiration pneumonitis possibly due to clozapine hyper-salivation. Delirium improved with stopping of ECT and clozapine. Clozapine monotherapy restarted to previous dosages in both cases without recurrence of delirium. Authors recommend for careful monitoring for delirium in ECT augmentation on high dose clozapine. Unilateral ECT may be preferred for augmenting clozapine.
摘要
很少有研究报道氯氮平与电休克治疗（ECT）联合用于精神分裂症的疗效和安全性；缺乏系统性研究。有报道称存在癫痫发作和意识模糊状态等副作用。作者报告了两例精神分裂症患者在接受ECT和氯氮平治疗后出现迟发性/持续性谵妄的病例，其中一例可能由于氯氮平引起的唾液分泌过多而发生吸入性肺炎。停止ECT和氯氮平治疗后谵妄症状改善。两例患者均重新开始使用之前剂量的氯氮平单药治疗，谵妄未复发。作者建议在高剂量氯氮平强化ECT治疗时要仔细监测谵妄情况。单侧ECT可能更适合用于强化氯氮平治疗。
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J ECT. 2009 Dec;25(4):280-1. doi: 10.1097/YCT.0b013e3181a2f867.
2
Acute clozapine intoxication.急性氯氮平中毒
J Clin Psychopharmacol. 2009 Jun;29(3):302-4. doi: 10.1097/JCP.0b013e3181a20c73.
3
Comparative study of clozapine, electroshock and the combination of ECT with clozapine in treatment-resistant schizophrenic patients.氯氮平、电击疗法以及电击疗法联合氯氮平治疗难治性精神分裂症患者的对比研究。
Pak J Biol Sci. 2007 Dec 1;10(23):4287-90. doi: 10.3923/pjbs.2007.4287.4290.
4
Treatment-resistant schizophrenia.难治性精神分裂症
Psychiatr Clin North Am. 2007 Sep;30(3):511-33. doi: 10.1016/j.psc.2007.04.001.
5
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6
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Clin Neuropharmacol. 2006 Jan-Feb;29(1):52-6. doi: 10.1097/00002826-200601000-00012.
7
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J ECT. 2004 Dec;20(4):254-7. doi: 10.1097/00124509-200412000-00012.
8
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9
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10
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