Arora Tarun, Maharshi Vikas, Rehan Harmeet S, Nagar Pravesh
J Basic Clin Physiol Pharmacol. 2017 Jan 1;28(1):85-87. doi: 10.1515/jbcpp-2016-0037.
Blepharospasm is one of the components of drug-induced Meige's syndrome which is reported to be caused by typical antipsychotics. Reports of blepharospasm or Meige's syndrome caused by atypical antipsychotics are rare.
A 30-year-old female patient presented to psychiatry out patient department (OPD) with chief complaints of inability to keep her eyes open for long and excessive blinking for 2 months, irritation of eyes, watery discharge from eyes and photophobia for last 1 month. The patient had been taking olanzapine 10 mg, sertraline 100 mg and divalproex sodium 500 mg per orally on once a day basis for the management of major depressive disorder with psychotic features for last 6 months. Routine blood analysis, thyroid function, EEG, MRI, lipid profile did not reveal any abnormality. Ocular examination was also within normal limits. Olanzapine was suspected as a culprit for the above symptoms of patient, so it was replaced with quetiapine 25 mg/day. Patient showed partial recovery of symptoms within 1 week and complete recovery within 2 months of stopping olanzapine. Causality of olanzapine-induced blepharospasm as per WHO-UMC scale was probable.
Olanzapine (atypical antipsychotics) should also be kept in the list of suspected drugs causing blepharospasm in psychotic patients on treatment although further similar evidences from observational studies and/or reports are needed to establish the causal relationship.
眼睑痉挛是药物性梅杰综合征的组成部分之一，据报道由典型抗精神病药物引起。非典型抗精神病药物引起眼睑痉挛或梅杰综合征的报道罕见。
一名30岁女性患者因主要症状为无法长时间睁眼、2个月来频繁眨眼、眼睛刺激感、近1个月眼睛流泪和畏光，前往精神科门诊就诊。该患者在过去6个月中一直每日口服奥氮平10毫克、舍曲林100毫克和丙戊酸镁500毫克，用于治疗伴有精神病性特征的重度抑郁症。常规血液分析、甲状腺功能、脑电图、磁共振成像、血脂检查均未发现异常。眼部检查也在正常范围内。怀疑奥氮平是患者上述症状病因，因此将其换为喹硫平，每日25毫克。停用奥氮平1周内患者症状部分缓解，2个月内完全恢复。根据世界卫生组织药物不良反应因果关系评价量表，奥氮平引起眼睑痉挛的因果关系很可能成立。
奥氮平（非典型抗精神病药物）也应列入治疗中精神病患者发生眼睑痉挛的可疑药物清单，不过还需要观察性研究和/或报告提供更多类似证据来确立因果关系。
