Department of Neuropsychiatry, St. Marianna University School of Medicine, Kawasaki, Japan.
Neuropsychopharmacol Rep. 2023 Mar;43(1):146-149. doi: 10.1002/npr2.12308. Epub 2022 Dec 8.
Postpsychotic depression is challenging to differentiate, yet it is clinically frequent, puts patients at risk for suicide, and affects their mental capacity. Treatment with antipsychotics for postpsychotic depression is desirable; however, there is no consensus on which antipsychotics are optimal.
We report the case of a young male patient with schizophrenia in his 20s who developed postpsychotic depression, including despair, overwhelming loss, humiliation, and suicidal ideation during treatment with paliperidone. As a result, we switched his medication to lurasidone, which relieved his depressive symptoms without any symptom relapse and his social functioning improved.
Postpsychotic depression has more psychic characteristics than behavioral. According to various international guidelines for the pharmacological treatment of schizophrenia, antipsychotics should be administered for depressive symptoms of schizophrenia. As evidenced in this case report, lurasidone may be a practical alternative for improving postpsychotic depression.
精神病后抑郁难以鉴别，但在临床上较为常见，会使患者有自杀风险，并影响其心理能力。抗精神病药治疗精神病后抑郁是可取的；然而，哪种抗精神病药是最佳的，目前尚无共识。
我们报告了一例 20 多岁的年轻男性精神分裂症患者，在使用帕利哌酮治疗期间出现精神病后抑郁，包括绝望、压倒性的失落、屈辱和自杀意念。因此，我们将他的药物换成了鲁拉西酮，这缓解了他的抑郁症状，没有任何症状复发，他的社会功能也得到了改善。
精神病后抑郁的精神特征多于行为特征。根据各种国际精神分裂症药物治疗指南，抗精神病药应用于治疗精神分裂症的抑郁症状。本病例报告表明，鲁拉西酮可能是改善精神病后抑郁的一种实用选择。
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