University of Genoa, Italy.
"San Paolo" Hospital, Savona, Italy.
Int J Psychiatry Med. 2014;48(2):103-8. doi: 10.2190/PM.48.2.c.
Ketamine is an anaesthetic and analgesic drug synthesized in the 1960s from phencyclidine. The recreational use of ketamine increased among the dance culture of techno and house music, in particular in clubs, discotheques, and rave parties. The psychotropic effects of ketamine are now well known and they range from dissociation to positive, negative, and cognitive schizophrenia-like symptoms. We report a case of a chronic oral consumption of ketamine which induced agitation, behavioral abnormalities, and loss of contact with reality in a poly-drug abuser; these symptoms persisted more than two weeks after the drug consumption had stopped. Antipsychotic treatment with paliperidone led to a successful management of the psychosis, getting a complete resolution of the clinical picture. Paliperidone has proven to be very effective in the treatment of ketamine-induced disorders. Moreover, the pharmacological action and metabolism of paliperidone are poorly dependent from the activity of liver enzymes, so that it seems to be one of the best second generation antipsychotics for the treatment of smokers and alcohol abusers.
氯胺酮是一种 20 世纪 60 年代从苯环己哌啶合成的麻醉和镇痛药物。氯胺酮在科技和浩室音乐的舞蹈文化中，特别是在俱乐部、迪斯科舞厅和锐舞派对中，被滥用于娱乐。氯胺酮的精神作用现在已经广为人知，其范围从分离到积极、消极和认知性精神分裂症样症状。我们报告了一例慢性口服氯胺酮的病例，该病例导致一名多药滥用者出现激动、行为异常和与现实失去联系；这些症状在药物停止使用后持续了两周以上。使用帕利哌酮进行抗精神病治疗成功地控制了精神病，完全解决了临床症状。帕利哌酮已被证明对治疗氯胺酮引起的疾病非常有效。此外，帕利哌酮的药理作用和代谢与肝酶的活性关系不大，因此它似乎是治疗吸烟者和酗酒者的最佳第二代抗精神病药物之一。
