Kirkpatrick Daniel, Smith Tyler, Kerfeld Mitchell, Ramsdell Taylor, Sadiq Hasnain, Sharma Arun
Department of Psychiatry, Creighton University School of Medicine, Omaha, NE 68178, USA.
Creighton University School of Pharmacy & Health Professions, Omaha, NE 68178, USA.
Case Rep Psychiatry. 2016;2016:6748947. doi: 10.1155/2016/6748947. Epub 2016 Mar 22.
With less than 1% of patients who use benzodiazepines being affected, paradoxical responses to benzodiazepines are rare. In this case report, we outline the course of an 80-year-old female who developed a paradoxical response to benzodiazepines. Significant medical and psychiatric history includes anxiety, mood disorder, hypothyroidism, bilateral mastectomy, goiter removal, and triple bypass. The patient presented with mental status changes, anxiety, motor restlessness, and paranoia. Over time, a temporal relationship between the severity of the patient's motor agitation and intake of alprazolam was observed. As doses of alprazolam were decreased, her motor agitation became less severe. In addition to motor agitation, the patient also demonstrated increased aggressiveness, a subjective feeling of restlessness, and increased talkativeness. As her dose of alprazolam decreased, many of the patient's symptoms were observed to decrease. This case report also discusses theories regarding the pathophysiology of paradoxical reactions to benzodiazepines, known risk factors, and appropriate treatment.
使用苯二氮䓬类药物的患者中受影响者不到1%，因此对苯二氮䓬类药物的矛盾反应很罕见。在本病例报告中，我们概述了一名80岁女性对苯二氮䓬类药物产生矛盾反应的过程。重要的医学和精神病史包括焦虑症、情绪障碍、甲状腺功能减退、双侧乳房切除术、甲状腺肿切除术和三次心脏搭桥手术。患者出现精神状态改变、焦虑、运动性不安和妄想症。随着时间的推移，观察到患者运动性激越的严重程度与阿普唑仑摄入量之间存在时间关系。随着阿普唑仑剂量的减少，她的运动性激越变得不那么严重。除了运动性激越外，患者还表现出攻击性增加、主观不安感和健谈。随着她的阿普唑仑剂量减少，患者的许多症状都有所减轻。本病例报告还讨论了关于苯二氮䓬类药物矛盾反应的病理生理学理论、已知的危险因素和适当的治疗方法。
