Yang Min, Cao Yudong, Wu Haishan, Zhang Li
Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders The Second Xiangya Hospital of Central South University Changsha Hunan China.
Kangning Psychiatric Hospital Linwu County Chenzhou China.
Clin Case Rep. 2024 May 3;12(5):e8852. doi: 10.1002/ccr3.8852. eCollection 2024 May.
Antipsychotic drug treatment is a commonly used therapeutic strategy in the field of psychiatry. Rational and standardized use of antipsychotics is crucial in clinical practice, and excessive use of antipsychotics may lead to severe toxic reactions. Thus, attention should be given to the monitoring of drug concentration and examination of organ function.
Excessive use of antipsychotics can cause a variety of adverse effects, including dysfunction of the liver and other organs. Liver cytochrome P450 (CYP450) enzymes play an important role in the metabolism of antipsychotics, and metabolizer types of CYP450 enzymes may influence the therapeutic effects. In this case report, we introduced a 52-year-old woman with a 23-year history of schizophrenia who took excessive doses of multiple antipsychotics and other herbal preparations for nearly 2 years, with poor response to treatment and minor side reactions to the antipsychotics. Pharmacogenomic examination showed that this patient was a CYP1A2 ultra-rapid metabolizer. The examination and treatment of this patient may provide a reference for the management of similar cases with poor response to an alarming tolerance for antipsychotics.
抗精神病药物治疗是精神病学领域常用的治疗策略。在临床实践中，合理规范使用抗精神病药物至关重要，过度使用可能导致严重的毒性反应。因此，应重视药物浓度监测和器官功能检查。
过度使用抗精神病药物可导致多种不良反应，包括肝脏等器官功能障碍。肝脏细胞色素P450（CYP450）酶在抗精神病药物代谢中起重要作用，CYP450酶的代谢类型可能影响治疗效果。在本病例报告中，我们介绍了一名患有23年精神分裂症病史的52岁女性，她过量服用多种抗精神病药物及其他草药制剂近2年，治疗反应不佳且对抗精神病药物副作用耐受性低。药物基因组学检查显示该患者为CYP1A2超快代谢者。该患者的检查和治疗可为类似对抗精神病药物反应不佳且耐受性惊人的病例管理提供参考。
