Lin, MD, Sun, MD, White, MD, Farrell, MD, Trestman, MD, Martin, MD, Kablinger, MD, Department of Psychiatry and Behavioral Science, Carilion Clinic-Virginia Tech Carilion School of Medicine, Roanoke, VA, USA; Virginia Tech Carilion School of Medicine, Roanoke, VA, USA. Zhang, BA, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA. Qi, MD, Department of Medical Psychology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.
Psychopharmacol Bull. 2022 Jun 27;52(3):72-80.
Buprenorphine and naloxone (Suboxone) is a combination medication-assisted treatment (MAT) for opioid use disorder. MAT withdrawal-induced psychosis is a rare clinical presentation. To our best knowledge, only three reports have summarized the characteristic manifestations of buprenorphine withdrawal psychosis, yet all of them were male. In this case report, we present a 41-year-old female patient with bipolar disorder and comorbid substance use disorder who developed new-onset psychosis and relapse of manic symptoms following abrupt discontinuation of Suboxone. Manic and psychotic symptoms remitted after a short-term hospitalization with the treatment of an antipsychotic and a mood stabilizer. In addition to discussing this case presentation and treatment approach, we review existing literature and discuss possible underlying mechanisms to enhance understanding of this clinical phenomenon.
丁丙诺啡和纳洛酮（Suboxone）是一种用于治疗阿片类药物使用障碍的联合药物辅助治疗（MAT）药物。MAT 戒断引起的精神病是一种罕见的临床表现。据我们所知，只有三份报告总结了丁丙诺啡戒断性精神病的特征表现，但都是男性。在本病例报告中，我们介绍了一位 41 岁的女性患者，患有双相情感障碍和合并物质使用障碍，在突然停止使用 Suboxone 后出现新发精神病和躁狂症状复发。抗精神病药物和心境稳定剂短期住院治疗后，躁狂和精神病症状缓解。除了讨论该病例的表现和治疗方法外，我们还回顾了现有文献并讨论了可能的潜在机制，以增强对这一临床现象的理解。
