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多重用药所致认知功能障碍及精神药物停用:一例神经心理学病例报告

Polypharmacy-induced cognitive dysfunction and discontinuation of psychotropic medication: a neuropsychological case report.

作者信息

Valtonen Jussi, Karrasch Mira

机构信息

Department of Psychology, New York University, 6 Washington Place, New York, NY 10003, USA.

Department of Psychology, Åbo Akademi University, Turku, Finland.

出版信息

Ther Adv Psychopharmacol. 2020 Apr 28;10:2045125320905734. doi: 10.1177/2045125320905734. eCollection 2020.

Abstract

Polypharmacy is common in patients with a diagnosis of bipolar disorder. Although polypharmacy is known to increase the risk of iatrogenic neurological conditions, the recovery of cognitive function after drug withdrawal has been rarely documented in psychiatric patients using standardized neuropsychological methods. We present a neuropsychological case report of patient SN, a 41-year-old woman who developed a socially and occupationally detrimental condition of cognitive dysfunction likely induced by long-term exposure to lithium and other psychiatric medications. To shed light on SN's cognitive deficits and their recovery after drug withdrawal, neuropsychological assessments were conducted before, and approximately 2 years after, lithium and other psychiatric drugs were discontinued. Selective cognitive impairments were observed before drug discontinuation in visuomotor speed, visuoperceptual reasoning and delayed visual memory. Partial, but not complete, recovery of function was observed 2 years after drug withdrawal.

摘要

多重用药在双相情感障碍患者中很常见。尽管已知多重用药会增加医源性神经疾病的风险,但使用标准化神经心理学方法记录精神病患者停药后认知功能恢复情况的研究却很少。我们报告了患者SN的神经心理学病例,这是一名41岁女性,长期接触锂盐和其他精神科药物可能导致了对社交和职业都有不利影响的认知功能障碍。为了阐明SN的认知缺陷及其停药后的恢复情况,在停用锂盐和其他精神科药物之前及停药约2年后进行了神经心理学评估。停药前在视觉运动速度、视觉感知推理和延迟视觉记忆方面观察到选择性认知障碍。停药2年后观察到功能有部分恢复,但未完全恢复。

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