Yang Chung-Hao, Juang Kai-Dih, Chou Po-Han, Chan Chin-Hong
From the Department of Psychiatry (C-HY, K-DJ, P-HC), Taichung Veterans Hospital, Taichung; and Department of Psychiatry (C-HC), Conde S. Januário General Hospital, Macau, China.
Medicine (Baltimore). 2016 Mar;95(9):e2930. doi: 10.1097/MD.0000000000002930.
A 17-year-old female with new-onset psychosis was treated with paliperidone. After increasing the paliperidone dose to 12 mg per day the patient developed a series of side effects; Tachycardia (140 bpm), severe drooling, restlessness, diaphoresis, whole-body tremor, inducible foot clonus, predominant lower limbs rigidity, bilateral pupil dilation, increased bowel sounds with watery diarrhea, and muscle hypertonicity. The symptoms subsided after stopping the paliperidone, and recurred after resuming paliperidone 9 mg per day. To our knowledge, this is the first case of a very clear and close relationship between the symptoms of serotonin syndrome and the use of paliperidone. We have to cautiously consider the diagnosis of serotonin syndrome in potential cases.
一名17岁新发精神病女性患者接受了帕利哌酮治疗。在将帕利哌酮剂量增加至每日12毫克后，患者出现了一系列副作用；心动过速（140次/分）、严重流涎、烦躁不安、多汗、全身震颤、可诱导的足阵挛、以下肢为主的强直、双侧瞳孔散大、肠鸣音亢进伴水样腹泻以及肌肉张力亢进。停用帕利哌酮后症状缓解，在恢复每日9毫克帕利哌酮治疗后症状复发。据我们所知，这是第一例血清素综合征症状与帕利哌酮使用之间存在非常明确且密切关系的病例。对于潜在病例，我们必须谨慎考虑血清素综合征的诊断。
