Raj B Neeraj, Manamohan N, Hegde Divya, Huded Chandrashekar B, Pradeep Johnson
Department of Psychiatry, St. John's Medical College and Hospital, Bengaluru, Karnataka, India.
Indian J Psychol Med. 2017 Mar-Apr;39(2):191-193. doi: 10.4103/0253-7176.203109.
Opioids are one of the commonly abused substances in India. Opioid withdrawal symptoms classically include severe muscle cramps, bone aches, autonomic symptoms, anxiety, restlessness, insomnia, and temperature dysregulation. However, reports of cases with delirium during withdrawal are few. A 25-year-old male with severe opioid withdrawal symptoms developed delirium. Investigations were normal. There were no comorbidities, no significant past history and family history. Patient treated for opioid dependence with tapering doses of lorazepam and clonidine. He was discharged with naltrexone. Patient lapsed 3 months later with similar presentation. Complications such as convulsions and delirium are recognized in alcohol withdrawal. However, these are rare as a feature of opioid withdrawal. This case illustrates the need for psychiatrists and physicians to be aware of the possibilities of delirium with opioid withdrawal and monitoring for the same is important because of its complications.
阿片类药物是印度常见的滥用物质之一。阿片类药物戒断症状的典型表现包括严重的肌肉痉挛、骨痛、自主神经症状、焦虑、烦躁不安、失眠和体温调节异常。然而，关于戒断期间出现谵妄的病例报告很少。一名25岁男性出现严重的阿片类药物戒断症状并发展为谵妄。检查结果正常。无合并症，无重大既往史和家族史。患者接受了逐渐减量的劳拉西泮和可乐定治疗阿片类药物依赖。他出院时服用了纳曲酮。3个月后患者复发，症状相似。惊厥和谵妄等并发症在酒精戒断中较为常见。然而，这些作为阿片类药物戒断的特征很少见。该病例表明，精神科医生和内科医生需要意识到阿片类药物戒断时出现谵妄的可能性，并且由于其并发症，对此进行监测很重要。
