Lo Yu-Chi, Peng Ying-Chieh
Ministry of Health and Welfare Kinmen Hospital, No. 2, Fuxing Rd., Jinhu Township, Kinmen County, 89142 Taiwan.
Bali Psychiatric Center, No. 33, Huafushan, Bali Dist., New Taipei City, 24936 Taiwan.
Ann Gen Psychiatry. 2017 Jun 14;16:25. doi: 10.1186/s12991-017-0148-0. eCollection 2017.
The effects of antipsychotic drug withdrawal have been inadequately studied. Case reports have described dyskinesia occurring in patients with several antipsychotics withdrawn, but studies on amisulpride withdrawal dyskinesia are lacking.
A 63-year-old man, who was diagnosed with schizophrenia at age 49, received amisulpride treatment since age 62. The dosage of amisulpride was reduced from 200 to 50 mg/day because of occurrence of akathisia during one admission. Severe withdrawal dyskinesia, mixed with dystonia and akathisia, was noted immediately after the dosage reduction. The abnormal involuntary movement showed improvement 2 weeks later when the dosage was increased to 100 mg/day.
Withdrawal dyskinesia and other abnormal involuntary movements could be noted in a patient with reduction of amisulpride dosage or sudden termination. Withdrawal dyskinesia may subsequently lead to persistent tardive dyskinesia. Therefore, withdrawal-emergent dyskinesia should be promptly identified, and appropriate medical interventions should be given early.
抗精神病药物撤药的影响尚未得到充分研究。病例报告描述了多种抗精神病药物撤药的患者出现运动障碍,但缺乏对阿立哌唑撤药后运动障碍的研究。
一名63岁男性,49岁时被诊断为精神分裂症,自62岁起接受阿立哌唑治疗。因一次住院期间出现静坐不能,阿立哌唑剂量从200毫克/天减至50毫克/天。剂量减少后立即出现严重的撤药运动障碍,伴有肌张力障碍和静坐不能。当剂量增加到100毫克/天时,异常的不自主运动在2周后有所改善。
阿立哌唑剂量减少或突然停药的患者可能会出现撤药运动障碍和其他异常不自主运动。撤药运动障碍可能随后导致持续性迟发性运动障碍。因此,应及时识别撤药后出现的运动障碍,并尽早给予适当的医学干预。