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抗精神病药和抗抑郁药致短暂性不安腿综合征 1 例报告。

Transitory restless arms syndrome in a patient with antipsychotics and antidepressants: a case report.

机构信息

Mental Health Center, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China.

Mental Health Center, West China Hospital, Sichuan University, No.28 Dianxin South Road, Chengdu, 610041, China.

出版信息

BMC Psychiatry. 2021 Sep 16;21(1):453. doi: 10.1186/s12888-021-03433-6.

Abstract

BACKGROUND

Restless arms syndrome (RAS) is characterized by uncomfortable aching or burning sensations in the arms. RAS is regarded as an upper limb variant of restless legs syndrome (RLS). The lack of specific diagnostic criteria makes it difficult to recognize the RAS. Therefore, RAS is usually neglected in clinical practice. Moreover, when a patient was diagnosed with RAS, the adjustment of medications was the first choice for doctors, which may make the patient's condition unstable.

CASE PRESENTATION

A 33-year-old woman was diagnosed with schizophrenia and major depressive disorder. Starting with 0.6 g/d amisulpride, 0.1 g/d quetiapine, 75 mg/d venlafaxine sustained-release tablets, the patient reported symptoms of RAS (itching arms) on the fourth day since the latest hospitalization. After ruling out other factors, her RAS was suspected to be induced by antidepressants or antipsychotics. Without medication adjustment, RAS spontaneously remitted.

CONCLUSIONS

This case suggests that psychiatrists should pay attention to RAS when using antipsychotics and/or antidepressants. Moreover, RAS may be transitory. When a patient manifests RAS, observation may be one choice instead of an immediate medication adjustment.

摘要

背景

不宁臂综合征(RAS)的特征是手臂出现不适的酸痛或烧灼感。RAS 被认为是不安腿综合征(RLS)的上肢变体。由于缺乏特定的诊断标准,使得 RAS 难以被识别。因此,RAS 在临床实践中通常被忽视。此外,当患者被诊断为 RAS 时,医生通常会选择调整药物,这可能会使患者的病情不稳定。

病例介绍

一位 33 岁女性,被诊断为精神分裂症和重度抑郁症。从 0.6g/d 氨磺必利、0.1g/d 喹硫平、75mg/d 文拉法辛缓释片开始,该患者在最近一次住院的第四天出现 RAS(手臂瘙痒)的症状。在排除其他因素后,怀疑她的 RAS 是由抗抑郁药或抗精神病药引起的。未进行药物调整,RAS 自发缓解。

结论

该病例提示精神科医生在使用抗精神病药和/或抗抑郁药时应注意 RAS。此外,RAS 可能是一过性的。当患者出现 RAS 时,观察可能是一种选择,而不是立即调整药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4078/8447733/abf7590d4f1a/12888_2021_3433_Fig1_HTML.jpg

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