Phull Jaspreet, Davies Steffan
Low Secure and Community Forensic Directorate, Nottinghamshire Healthcare NHS Trust, Nottingham, UK.
BMJ Case Rep. 2011 Dec 20;2011:bcr0820114671. doi: 10.1136/bcr.08.2011.4671.
This case report provides a different perspective on the management of a patient with a psychotic illness. The detained patient, a man aged 50, had specific delusional beliefs about toxins affecting his kidneys, such that he needed to drink water to 'detoxify' himself. This resulted in him developing life-threatening hyponatraemia. It became clear that he was very resistant to taking oral medication and was reluctant to engage with any psychological treatment. A novel approach was considered, involving the 'off licence' use of short acting intramuscular olanzapine for the successful treatment of the psychotic illness. The case demonstrates the safe use of intramuscular olanzapine for 155 days, which is the longest reported case for the use of intramuscular olanzapine for the treatment of a psychotic illness. The individual was later discharged on oral olanzapine.
本病例报告为精神病患者的管理提供了一个不同的视角。该被拘留患者为一名50岁男性，对影响其肾脏的毒素持有特定的妄想信念，以至于他需要喝水来“排毒”。这导致他患上了危及生命的低钠血症。很明显，他非常抗拒口服药物治疗，并且不愿接受任何心理治疗。于是考虑了一种新方法，即“超适应症”使用短效肌内注射奥氮平来成功治疗精神病。该病例证明了肌内注射奥氮平安全使用了155天，这是报道的使用肌内注射奥氮平治疗精神病的最长病例。该患者后来出院，改为口服奥氮平。
