Pandit Shradha, Mahat Krishna
Internal Medicine, Bandipur Hospital, Bandipur, NPL.
Internal Medicine, Ascension St. John Hospital, Detroit, USA.
Cureus. 2023 Jul 26;15(7):e42491. doi: 10.7759/cureus.42491. eCollection 2023 Jul.
Dysphagia has been associated with antipsychotic drug use. This case report describes the management of dysphagia in a psychiatric patient who presented to the emergency department from a psychiatric facility after choking on a hot dog. The patient was on risperidone 4 mg, initiated a month prior to treat acute psychosis. Foreign body removal from the distal trachea was performed by bronchoscopy, followed by a swallow evaluation by the speech and swallow team. The patient exhibited severe oropharyngeal dysphagia, leading to aspiration pneumonia and subsequent enteral feeding through a nasojejunal tube. Changes in medication from risperidone to aripiprazole, along with a short course of benztropine and dietary modifications, were implemented, with gradual improvement in swallowing function observed during the hospital stay. The patient's complex medical and psychiatric history contributed to a prolonged hospital stay.
吞咽困难与抗精神病药物的使用有关。本病例报告描述了一名精神病患者吞咽困难的处理情况,该患者在食用热狗时窒息后从精神病院被送往急诊科。患者正在服用4毫克利培酮,该药在一个月前开始使用以治疗急性精神病。通过支气管镜从远端气管取出异物,随后由言语和吞咽治疗团队进行吞咽评估。患者表现出严重的口咽吞咽困难,导致吸入性肺炎,随后通过鼻空肠管进行肠内喂养。实施了从利培酮到阿立哌唑的药物更换,以及短期使用苯海索和饮食调整,住院期间吞咽功能逐渐改善。患者复杂的医疗和精神病史导致住院时间延长。