Petrous Jeremy, Furmaga Kevin
Psychiatry, Pine Rest Christian Mental Health Services, Grand Rapids, Michigan, USA.
BMJ Case Rep. 2017 Oct 23;2017:bcr-2017-222037. doi: 10.1136/bcr-2017-222037.
A 59-year-old woman on daily peritoneal dialysis for end-stage renal failure received care at an outpatient psychiatric clinic for her diagnoses that include major depressive disorder, generalised anxiety disorder and insomnia disorder. Although there was partial improvement in the patient's mood and anxiety symptoms with antidepressant treatment, insomnia remained a persistent complaint despite adequate trials of different sleep medications. The novel hypnotic, suvorexant (Belsomra, Merck & Co.) was then initiated at the recommended bedtime dose of 10 mg and was followed by a 15 mg dose the following night. Within an hour after taking her second suvorexant dose, the severity of patient's depression symptoms worsened and was accompanied by new onset of suicidal thoughts.
一名59岁的女性因终末期肾衰竭接受每日腹膜透析治疗，她在一家门诊精神科诊所接受治疗，其诊断包括重度抑郁症、广泛性焦虑症和失眠症。尽管使用抗抑郁药治疗后患者的情绪和焦虑症状有部分改善，但尽管对不同的睡眠药物进行了充分试验，失眠仍然是一个持续存在的问题。随后开始使用新型催眠药苏沃雷生（Belsomra，默克公司），推荐就寝剂量为10毫克，次日晚上剂量增加至15毫克。在服用第二剂苏沃雷生后一小时内，患者的抑郁症状加重，并伴有自杀念头的新出现。
