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一名年轻健康男性因三环类抗抑郁药引发的抗胆碱能性谵妄

Tricyclic Antidepressant-Induced Anticholinergic Delirium in a Young Healthy Male Individual.

作者信息

King Matthew, Ashraf Nauman

机构信息

Ozark Center, Freeman Hospital, Kansas City University of Medicine and Biosciences, 2002 Hampshire Terrace apt 2, Joplin, MO, 64804, USA.

Department of Behavioral Sciences, OSU-COM, Columbus, OH, USA.

出版信息

Drug Saf Case Rep. 2018 Jan 2;5(1):1. doi: 10.1007/s40800-017-0069-5.

Abstract

The tricyclic antidepressants, while older, still have their place in the treatment of depression today. They are efficacious but less selective and thus have the potential of eliciting many side effects. Anticholinergic delirium is a potential complication when using a tricyclic antidepressant or other anticholinergic agent. Following the Naranjo algorithm, this case report describes a probable amitriptyline-induced delirium in a previously healthy, 36-year-old Caucasian male individual after he promptly resumed his nightly 200-mg amitriptyline dose, following abrupt discontinuation of the medication 1 week earlier. This case emphasizes the importance of drug titration/tapering and therapeutic drug monitoring of patients taking tricyclic antidepressants.

摘要

三环类抗抑郁药虽然问世已久,但在如今的抑郁症治疗中仍有一席之地。它们疗效显著,但选择性较差,因此有可能引发多种副作用。使用三环类抗抑郁药或其他抗胆碱能药物时,抗胆碱能谵妄是一种潜在的并发症。本病例报告依据纳朗霍算法,描述了一名此前健康的36岁白人男性,在1周前突然停用每晚200毫克阿米替林剂量后又迅速恢复用药后,可能由阿米替林诱发的谵妄。该病例强调了对服用三环类抗抑郁药的患者进行药物滴定/逐渐减量以及治疗药物监测的重要性。

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本文引用的文献

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Delirium and epilepsy.谵妄与癫痫。
Dialogues Clin Neurosci. 2003 Jun;5(2):187-200. doi: 10.31887/DCNS.2003.5.2/pkaplan.
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An approach to drug induced delirium in the elderly.老年人药物性谵妄的一种处理方法。
Postgrad Med J. 2004 Jul;80(945):388-93. doi: 10.1136/pgmj.2003.017236.
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Drugs that induce delirium.诱发谵妄的药物。
Dement Geriatr Cogn Disord. 1999 Sep-Oct;10(5):412-5. doi: 10.1159/000017180.
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The problems of anticholinergic adverse effects in older patients.老年患者抗胆碱能不良反应的问题。
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