Bavle Amar D, Kumar Girish M N
Department of Psychiatry, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.
Indian J Psychol Med. 2013 Oct;35(4):423-4. doi: 10.4103/0253-7176.122249.
Tardive syndromes are much lower in prevalence in second generation antipsychotics (SGA) than in the typical antipsychotics. Although, olanzapine, which is an SGA, has a high risk of causing weight gain, metabolic syndrome, raised blood sugar, and dyslipidemias; it is widely used as the risk of developing extrapyramidal syndromes (EPS) is low. Among the various forms of EPS, tardive syndromes are the most feared, tardive dyskinesia, tardive akathisia, and tardive dystonia are the commonest tardive syndromes, the others being less common. Tardive oculogyric crises (TOC) are a rare form of tardive dystonia. This patient had TOC with prolonged unsupervised treatment with low-dose olanzapine. Added to that, she developed weight gain that was alarmingly high and such high gain in weight with olanzapine, to our knowledge, has not been reported. She responded to a low dose of trihexiphenydyl, and on stopping olanzapine and adding aripiprazole, has started losing weight.
第二代抗精神病药物（SGA）所致迟发性综合征的患病率远低于典型抗精神病药物。尽管作为一种SGA的奥氮平有导致体重增加、代谢综合征、血糖升高和血脂异常的高风险；但因其发生锥体外系综合征（EPS）的风险较低，所以被广泛使用。在各种形式的EPS中，迟发性综合征最令人担忧，迟发性运动障碍、迟发性静坐不能和迟发性肌张力障碍是最常见的迟发性综合征，其他则较少见。迟发性动眼危象（TOC）是迟发性肌张力障碍的一种罕见形式。该患者因长期在未受监督的情况下接受低剂量奥氮平治疗而出现TOC。此外，她体重增加惊人，据我们所知，奥氮平导致如此高的体重增加尚未见报道。她对低剂量的苯海索有反应，在停用奥氮平并加用阿立哌唑后，体重开始下降。
