Tandon R, Dutchak D, Greden J F
Schizophrenia Program, University of Michigan Medical Center, Ann Arbor 48109-0120.
Br J Psychiatry. 1989 May;154:712-4. doi: 10.1192/bjp.154.5.712.
A 27-year-old neuroleptic-stabilised schizophrenic patient presented with a three-day history of psychomotor retardation, disturbed sleep, and social and emotional withdrawal following reduction of his anticholinergic dosage; his symptoms had intensified after an increase in neuroleptic dosage, based on a diagnosis of psychotic decompensation. Recognition of a cholinergic syndrome and institution of appropriate anticholinergic treatment resulted in rapid improvement. The clinical distinction between a cholinergic overdrive state and schizophrenic exacerbation, while sometimes difficult, can be critical in selecting appropriate management.
一名27岁的精神分裂症患者，其病情在抗精神病药物稳定控制下，在减少抗胆碱能药物剂量后，出现了三天的精神运动迟缓、睡眠障碍、社交和情感退缩症状；基于精神病性失代偿的诊断，在增加抗精神病药物剂量后，其症状加重。识别胆碱能综合征并采取适当的抗胆碱能治疗后，症状迅速改善。胆碱能亢进状态与精神分裂症加重之间的临床鉴别有时虽困难，但对选择合适的治疗方法至关重要。
