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帕利哌酮长效注射剂治疗一名经期精神症状波动的青少年精神分裂症患者:病例报告

Paliperidone long-acting injection in the treatment of an adolescent with schizophrenia with fluctuating mental symptoms during menstrual period: a case report.

作者信息

Wang Feng, Chen Juan, Guo Linglin, Li Zhixiong, Li Zhe

机构信息

Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.

West China School of Nursing, Sichuan University, Chengdu, China.

出版信息

Front Psychiatry. 2023 Oct 6;14:1276983. doi: 10.3389/fpsyt.2023.1276983. eCollection 2023.

Abstract

BACKGROUND

The treatment of schizophrenia, a chronic disabling psychiatric disorder, mainly relies on antipsychotics to control the disease and improve clinical symptoms. Various medication options are available, and differences in treatment effects, even for the same medication, have been noted. Treatment efficacy is correlated with the patient's sex, age, and physical condition. When a drug fails to achieve the desired effect or the symptoms are unstable, the drug dose is often increased or a change in medication is advised according to the patient's situation.

CASE PRESENTATION

We report the case of a 16 years-old girl with schizophrenia and apparent psychotic symptoms. According to the genetic testing results, the symptoms were effectively controlled, and she was discharged from the hospital with the prescription of paliperidone sustained-release tablets. During the follow-up, her symptoms fluctuated during menstrual period, causing her great distress. Furthermore, her compliance gradually declined during the following 2 years of treatment, and the medication was often discontinued. We changed the drug from an oral tablet to an injection preparation while maintaining the active ingredients of the drug. The patient's symptoms were significantly controlled, and no fluctuation of symptoms occurred during the menstrual cycle.

CONCLUSION

Long-acting antipsychotic injections can be administered to female adolescents with schizophrenia who experience fluctuating psychotic symptoms during menstruation. This technique can ensure both consistency of medication and improvement in clinical symptoms.

摘要

背景

精神分裂症是一种慢性致残性精神障碍,其治疗主要依靠抗精神病药物来控制病情并改善临床症状。有多种药物可供选择,并且已注意到即使使用相同药物,治疗效果也存在差异。治疗效果与患者的性别、年龄和身体状况相关。当药物未能达到预期效果或症状不稳定时,通常会根据患者情况增加药物剂量或建议更换药物。

病例介绍

我们报告一例16岁患有精神分裂症且有明显精神病症状的女孩。根据基因检测结果,症状得到有效控制,她出院时开具了帕利哌酮缓释片的处方。在随访期间,她的症状在月经期波动,给她带来极大困扰。此外,在接下来的2年治疗中她的依从性逐渐下降,经常停药。我们将药物从口服片剂改为注射制剂,同时保持药物的活性成分。患者的症状得到显著控制,月经周期中未出现症状波动。

结论

对于月经期精神病症状波动的女性青少年精神分裂症患者,可给予长效抗精神病注射剂。该技术既能确保用药的一致性,又能改善临床症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd74/10587406/767a897678bf/fpsyt-14-1276983-g001.jpg

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