Holka-Pokorska Justyna, Piróg-Balcerzak Agnieszka, Stefanowicz Artur
Psychiatr Pol. 2014 Sep-Oct;48(5):901-16. doi: 10.12740/pp/24434.
A few cases of psychosis induced by clomiphene citrate have been described so far. However, data on the prevalence of psychotic symptoms among women treated for infertility are inconclusive. Still a little is known about possible psychiatric complications of medications used in assisted reproduction techniques (ART). We present a case of a patient who developed transient psychotic symptoms in the course of the in vitro fertilization procedures. To our kiiowledge, this is the first case of 'mid-stimulation psychosis', which has been observed during ART using clomiphene.citrate and bromocriptine. The aim of this study is to describe the determinants ofpharmacotherapy undertaken in ART,.which can result in the development of psychotic symptoms.
The Case presentation.
The use of clomiphene citrate for ovulation induction in combination with bromocriptine used for chronic hyperprolactinemia is a likely mechanism that might have triggered psychotic symptoms in the case presented. However, combination therapy with clomiphen citrate and.bromocriptine may be the pharmacological model of hyper-dopaminergia followed by chaotic changes in serum estrogen levels and might lead to an increased sensitivity of dopamine receptors. The above therapeutic schema may increase susceptibility to the development of psychotic symptoms in treated women. This impact should be considered in the case of any psychotic complications in patients undergoing assisted reproduction techniques
迄今为止,已有少数关于枸橼酸氯米芬诱发精神病的病例报道。然而,关于接受不孕症治疗的女性中精神病症状的患病率数据尚无定论。对于辅助生殖技术(ART)中使用的药物可能引发的精神科并发症,我们仍知之甚少。我们报告一例在体外受精过程中出现短暂精神病症状的患者。据我们所知,这是首例在使用枸橼酸氯米芬和溴隐亭的ART过程中观察到的“刺激中期精神病”。本研究的目的是描述ART中药物治疗的决定因素,这些因素可能导致精神病症状的出现。
病例报告。
在该病例中,使用枸橼酸氯米芬诱导排卵并联合使用溴隐亭治疗慢性高泌乳素血症可能是引发精神病症状的机制。然而,枸橼酸氯米芬和溴隐亭联合治疗可能是高多巴胺能的药理学模式,随后血清雌激素水平发生紊乱变化,并可能导致多巴胺受体敏感性增加。上述治疗方案可能会增加接受治疗女性出现精神病症状的易感性。对于接受辅助生殖技术的患者出现的任何精神科并发症,都应考虑到这种影响。