Sun Fengli, Tao Hejian, Jin Weidong
Department of Psychiatry, Zhejiang Province Mental Health Center, Zhejiang Province Tongde Hospital, Hangzhou, Zhejiang, China.
Second Clinical College, Zhejiang Chinese Medical University, Hangzhou, China.
Psychiatry Clin Psychopharmacol. 2022 Dec 1;32(4):351-354. doi: 10.5152/pcp.2022.22441. eCollection 2022 Dec.
Restless back syndrome is characterized by uncomfortable pain, burning, ant crawling, or itching sensations in the back. Restless back syndrome is regarded as a back variant of restless legs syndrome. The lack of specific diagnostic criteria makes it difficult to recognize the restless back syndrome, which is usually neglected in clinical practice. Moreover, when a patient was diagnosed with restless back syndrome, the adjustment of medications was the first choice for doctors, which may make the patient's condition unstable. To describe the restless back syndrome and collect and review the related lecture, and the possible mechanism of restless back syndrome was analyzed. A 50-year-old man was diagnosed with schizophrenia 15 years ago. Starting with 25 mg/day aripiprazole, which was switched to amisulpride 0.6 g/day due to no effectiveness, the patient reported symptoms of restless back syndrome in the 2 weeks since the treatment with 0.6 g/day of amisulpride. With the reduction of amisulpride adjustment, restless back syndrome spontaneously remitted. The central dopaminergic dysfunction may play an important role in the development of restless back syndrome. This case suggests that psychiatrists should pay attention to restless back syndrome when using antipsychotics. Moreover, when a patient manifests restless back syndrome, observation or decreasing medication may be one choice.
背部不安综合征的特征是背部出现不适的疼痛、烧灼感、蚁走感或瘙痒感。背部不安综合征被视为不安腿综合征的一种背部变体。由于缺乏特定的诊断标准，背部不安综合征难以被识别，在临床实践中通常被忽视。此外，当患者被诊断为背部不安综合征时，医生首先选择调整药物，这可能会使患者的病情不稳定。为了描述背部不安综合征并收集和回顾相关文献，并分析了背部不安综合征可能的发病机制。一名50岁男性15年前被诊断为精神分裂症。最初使用阿立哌唑25毫克/天，因无效改用氨磺必利0.6克/天，患者在使用0.6克/天氨磺必利治疗后的2周内出现了背部不安综合征的症状。随着氨磺必利剂量的减少，背部不安综合征自行缓解。中枢多巴胺能功能障碍可能在背部不安综合征的发病中起重要作用。该病例提示精神科医生在使用抗精神病药物时应注意背部不安综合征。此外，当患者出现背部不安综合征时，观察或减少用药可能是一种选择。
