Faunce Alina F, Tennant William B
Research, Alabama College of Osteopathic Medicine, Dothan, USA.
Psychiatry, Turning Point Psychiatry, Cullman Regional Medical Center, Cullman, USA.
Cureus. 2024 Aug 28;16(8):e68047. doi: 10.7759/cureus.68047. eCollection 2024 Aug.
Cotard's delusion is a rare and complex condition marked by profound detachment from reality and nihilistic beliefs about decay and mortality, often stemming from underlying psychiatric or neurological issues. In the case of Mr. B, a 44-year-old man with a history of seizure disorder and major depressive disorder (MDD) with psychotic features, his delusions included beliefs that his right leg was decaying and that he was deceased. Despite treatment attempts with various combinations of antidepressants and antipsychotics, his delusions worsened, achieving substantial relief only through venlafaxine monotherapy. This outcome, highlighting the potential inefficacy of antipsychotics and the success of venlafaxine, underscores the need for better understanding and additional pharmacological research into Cotard's delusion, particularly within the context of MDD with psychotic features. The exact mechanism through which venlafaxine achieved a positive response remains unknown, necessitating further comprehensive studies.
科塔尔妄想症是一种罕见且复杂的病症，其特征是与现实深度脱节，以及对腐烂和死亡持有虚无主义信念，通常源于潜在的精神或神经问题。在B先生的案例中，他是一名44岁的男性，有癫痫病史以及伴有精神病性特征的重度抑郁症（MDD），他的妄想包括认为自己的右腿正在腐烂以及自己已经死亡。尽管尝试了多种抗抑郁药和抗精神病药的联合治疗，但他的妄想仍不断恶化，仅通过文拉法辛单一疗法才取得了显著缓解。这一结果凸显了抗精神病药物可能无效以及文拉法辛的成功，强调了需要更好地理解科塔尔妄想症并开展更多药理学研究，尤其是在伴有精神病性特征的重度抑郁症背景下。文拉法辛产生积极反应的确切机制尚不清楚，因此需要进一步进行全面研究。
