Moss J H, Stewart D E
Can J Psychiatry. 1986 Dec;31(9):865-6. doi: 10.1177/070674378603100916.
This case report describes a 63 year old woman with a nineteen year history of Huntington's Chorea who had been successfully treated with tetrabenazine for 9 years. During a hospital admission for an unrelated medical illness, she was given two doses of chlorpromazine 25 mg for a vascular headache and within hours became mute, extremely rigid, and unable to move or swallow. The consultation psychiatrist confirmed the diagnosis of severe drug-induced parkinsonism by intramuscular injection of benztropine mesylate which resulted in a dramatic immediate improvement. Both chlorpromazine and tetrabenazine were discontinued and the patient's severe parkinsonian symptoms completely abated on oral benztropine mesylate. Tetrabenazine alone, was restarted after 48 hours to control her Huntington's Chorea and there was no recurrence of parkinsonism. (Past history revealed the patient to have tolerated the same doses of chlorpromazine and tetrabenazine when given separately.) Previous literature reports concurrent safe use of antipsychotics with tetrabenazine, but this case report would suggest caution, and early discontinuance in the event of parkinsonism.
本病例报告描述了一位患有亨廷顿舞蹈症19年的63岁女性，她已成功接受丁苯那嗪治疗9年。在因无关疾病住院期间，她因血管性头痛服用了两剂25毫克的氯丙嗪，数小时内便出现缄默、极度僵硬，无法移动或吞咽。会诊精神科医生通过肌肉注射甲磺酸苯扎托品确诊为严重药物性帕金森症，注射后症状立即显著改善。氯丙嗪和丁苯那嗪均停药，患者的严重帕金森症状在口服甲磺酸苯扎托品后完全消退。48小时后单独重新启用丁苯那嗪以控制她的亨廷顿舞蹈症，帕金森症未复发。（既往史显示患者单独使用相同剂量的氯丙嗪和丁苯那嗪时能够耐受。）既往文献报道抗精神病药物与丁苯那嗪可同时安全使用，但本病例报告提示应谨慎用药，若发生帕金森症应尽早停药。
