Dorson P G, Crismon M L
Clinical Division, College of Pharmacy, University of Texas, Austin 78712.
Drug Intell Clin Pharm. 1988 Oct;22(10):776-8. doi: 10.1177/106002808802201007.
Sudden death has been reported in psychiatric patients before and after the advent of antipsychotic medications. A case of sudden death following chlorpromazine administration in a schizophrenic patient is presented. After receiving a mean daily dose of 780 mg for five days, the patient died suddenly. Laboratory work on day 2 of hospitalization indicated a calculated creatinine clearance of 14 ml/min. The autopsy was noncontributory except for a blood chlorpromazine concentration of 1534 ng/ml. The potential cause of death in this patient and the proposed mechanisms of sudden death in psychiatric patients are discussed. The effect of renal and hepatic disease on chlorpromazine plasma concentrations is presented. This case is the first report of sudden death in a psychiatric patient with a documented elevated antipsychotic plasma concentration. It is also the first report of an elevated chlorpromazine blood concentration in a patient with renal insufficiency.
在抗精神病药物出现之前和之后，都有关于精神科患者猝死的报道。本文介绍了一例精神分裂症患者在服用氯丙嗪后猝死的病例。该患者连续五天平均每日服用780毫克氯丙嗪后突然死亡。住院第二天的实验室检查显示计算得出的肌酐清除率为14毫升/分钟。尸检未发现有价值的线索，仅发现血液中氯丙嗪浓度为1534纳克/毫升。本文讨论了该患者可能的死亡原因以及精神科患者猝死的推测机制。还介绍了肾脏和肝脏疾病对氯丙嗪血浆浓度的影响。该病例是第一例有记录显示抗精神病药物血浆浓度升高的精神科患者猝死报告。也是第一例肾功能不全患者氯丙嗪血药浓度升高的报告。
