Boland Xavier, Chhabra Preeti
BOLAND and CHHABRA: West London Mental Health NHS Trust, London, UK.
J Psychiatr Pract. 2019 Mar;25(2):135-138. doi: 10.1097/PRA.0000000000000372.
A 26-year-old man with a history of longstanding treatment-resistant schizophrenia gained a substantial amount of weight while being treated with high-dose combination antipsychotic therapy with olanzapine and amisulpride. The patient was switched to combination therapy with olanzapine and aripiprazole to reverse a drug-induced hyperprolactinemia. The patient subsequently lost over 37 lb in weight over a period of 4 months despite no measurable changes in his dietary caloric intake or in his level of physical activity and without any identifiable medical cause on physical investigation.
The timing of the weight loss following the addition of aripiprazole and the exclusion of a medical cause point toward a causal relationship between the change in the patient's medication and the dramatic change in his body weight. We propose that, in a subgroup of patients, the addition of aripiprazole to their antipsychotic regime (without stopping the offending antipsychotic in terms of weight gain) can result in very significant weight loss and even the reversal of antipsychotic-induced weight gain.
一名26岁有长期难治性精神分裂症病史的男性，在接受奥氮平和氨磺必利高剂量联合抗精神病治疗期间体重显著增加。该患者改用奥氮平和阿立哌唑联合治疗以纠正药物引起的高催乳素血症。尽管患者的饮食热量摄入和身体活动水平没有可测量的变化，且体格检查未发现任何可识别的医学原因，但在4个月的时间里体重减轻了超过37磅。
添加阿立哌唑后体重减轻的时间以及排除医学原因表明，患者药物治疗的改变与体重的显著变化之间存在因果关系。我们提出，在一部分患者中，在其抗精神病治疗方案中添加阿立哌唑（在体重增加方面不停止引起问题的抗精神病药物）可导致非常显著的体重减轻，甚至逆转抗精神病药物引起的体重增加。
