Aiyer Rohit, Jain Vivek, Bhatia Anurag, Mekinulov Boris, Gungor Semih
Department of Psychiatry, Hofstra Northwell Health - Staten Island University Hospital, Staten Island, NY, USA.
Department of Anesthesiology, Hofstra Northwell Health - Staten Island University Hospital, Staten Island, NY, USA.
Pain Manag. 2017 May;7(3):171-173. doi: 10.2217/pmt-2016-0058. Epub 2017 Feb 28.
We report a case of a 57-year-old male patient with intrathecal morphine pump failure who presented with psychosis as part of a clinical presentation of opioid withdrawal. The patient was being treated for chronic back pain with an intrathecal morphine pump for several years. The patient spontaneously started to experience psychotic symptoms which included disorganized thinking, delusional thoughts, paranoia, auditory and visual hallucinations. Upon interrogation of intrathecal pump, it was found not to be functioning, thereby not delivering intrathecal morphine. After opioid rotation with administration of oral oxycodone, the patient's psychosis improved dramatically within a few days, clinically confirming psychosis due to morphine withdrawal. Therefore, it is important for physicians to consider opioid withdrawal in patients experiencing isolated psychosis.
我们报告一例57岁男性患者，其鞘内吗啡泵出现故障，表现为精神病性症状，这是阿片类药物戒断临床表现的一部分。该患者使用鞘内吗啡泵治疗慢性背痛数年。患者自发开始出现精神病性症状，包括思维紊乱、妄想、偏执、听觉和视觉幻觉。检查鞘内泵时，发现其无法正常工作，因此未输送鞘内吗啡。在换用口服羟考酮进行阿片类药物轮换后，患者的精神病性症状在几天内显著改善，从临床角度证实了吗啡戒断所致的精神病。因此，对于出现孤立性精神病的患者，医生考虑阿片类药物戒断情况很重要。
