Smart Chris, McAllister-Williams Hamish, Cousins David Andrew
Academic Psychiatry, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
Regional Affective Disorders Service, Northumberland Tyne and Wear NHS Foundation Hospital Trust, Newcastle upon Tyne, UK, and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
Ther Adv Psychopharmacol. 2018 Jan;8(1):59-61. doi: 10.1177/2045125317718810. Epub 2017 Jul 10.
Dopamine receptor antagonists can be effective in psychotic depression but response is not assured. Visual hallucinations may arise from a dysregulation of brain cholinergic systems and acetylcholinesterase inhibitors (AChEIs) can treat such hallucinations in dementia with Lewy bodies (DLB). AChEIs have been used in schizophrenia with some success but their efficacy and tolerability in psychotic depression is unclear. This striking case illustrates AChEIs specifically targeting multimodal hallucinations in treatment-resistant depression. To our knowledge it is the first case report to do so. It highlights the value of delineating psychopathology when considering novel interventions. This case also shows the idiosyncratic nature of side effects and the importance of pursuing different drugs within class.
多巴胺受体拮抗剂对精神病性抑郁症可能有效，但疗效不能保证。视幻觉可能源于脑胆碱能系统失调，乙酰胆碱酯酶抑制剂（AChEIs）可治疗路易体痴呆（DLB）中的此类幻觉。AChEIs已用于治疗精神分裂症并取得了一定成功，但其在精神病性抑郁症中的疗效和耐受性尚不清楚。这个引人注目的病例说明了AChEIs专门针对难治性抑郁症中的多模态幻觉。据我们所知，这是第一例这样的病例报告。它强调了在考虑新的干预措施时描述精神病理学的价值。该病例还显示了副作用的独特性质以及在同一类药物中使用不同药物的重要性。
