Kamada Yasuhiko, Sakamoto Ai, Kotani Sayoko, Masuyama Hisashi
Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Japan.
Department of Obstetrics and Gynecology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
J Obstet Gynaecol Res. 2018 Apr;44(4):797-800. doi: 10.1111/jog.13578. Epub 2018 Jan 23.
Dienogest is a fourth-generation progestin that is used for the treatment of endometriosis. We report a case of premenstrual mood changes in a patient with schizophrenia who was unresponsive to conventional treatment but successfully managed with dienogest. A 37-year-old Japanese woman with schizophrenia was referred to our hospital and diagnosed with premenstrual exacerbation of schizophrenia or coexisting premenstrual dysphoric disorder with schizophrenia. She had already taken maximal doses of selective serotonin reuptake inhibitors and combined oral contraceptives produced intolerable side effects. Gonadotropin-releasing hormone agonist treatment was effective but was not suitable for long-term use. Dienogest was initiated to treat pelvic endometriosis and produced subsequent improvements in mental status. The patient was able to return to work and did not indicate any adverse effects. This case suggests that dienogest may be useful for managing premenstrual mood changes in patients with schizophrenia, that it can be safely administered over long periods of time.
地诺孕素是一种用于治疗子宫内膜异位症的第四代孕激素。我们报告了一例精神分裂症患者经传统治疗无效，但用地诺孕素成功治疗经前情绪变化的病例。一名37岁的日本精神分裂症女性被转诊至我院，诊断为精神分裂症经前加重或合并经前烦躁障碍伴精神分裂症。她已经服用了最大剂量的选择性5-羟色胺再摄取抑制剂，联合口服避孕药产生了无法耐受的副作用。促性腺激素释放激素激动剂治疗有效，但不适合长期使用。开始用地诺孕素治疗盆腔子宫内膜异位症，随后精神状态有所改善。患者能够重返工作岗位，且未出现任何不良反应。该病例表明，地诺孕素可能有助于治疗精神分裂症患者的经前情绪变化，且可长期安全给药。
