Omri Moujib, Ferhi Mohamed, Rauschenbach Catrin, Ibrahim Alaa, Oliveira Galvao Mariza, Hamm Oliver
Psychiatry and Psychotherapy Department, Klinikum Mutterhaus der Borromäerinnen, Trier, DEU.
Psychiatry Department, Hôpital Universitaire Mohamed Taher Maamouri, Nabeul, TUN.
Cureus. 2024 Nov 19;16(11):e73980. doi: 10.7759/cureus.73980. eCollection 2024 Nov.
Psychotic manifestations of iatrogenic origin are common in clinical practice, and it is essential to rule out organic and iatrogenic causes before attributing symptoms to psychiatric disorders. Bupropion, an atypical antidepressant used for treating depression and aiding smoking cessation, has been linked to rare instances of psychosis, especially in patients with risk factors like substance use, older age, or history of head trauma. This report describes the case of a 52-year-old man with recurrent depression who developed a bupropion-induced psychotic episode following an increase in dose to 300 mg/day. He presented with persecutory delusions, although he had no history of psychosis or contributing factors. With the withdrawal of bupropion and the addition of risperidone, the patient's psychotic symptoms resolved within a week. The report takes a look at the recent literature since 2010 and the role of bupropion's dopaminergic effects, its ability to lead to psychosis, and the risk factors associated with this problem. Although there are no guidelines, in some cases antipsychotics such as risperidone have been helpful in reversing bupropion-induced psychosis after discontinuation of the drug.
医源性精神病性表现在临床实践中很常见，在将症状归因于精神障碍之前，排除器质性和医源性病因至关重要。安非他酮是一种用于治疗抑郁症和辅助戒烟的非典型抗抑郁药，与罕见的精神病病例有关，尤其是在有物质使用、年龄较大或头部外伤史等危险因素的患者中。本报告描述了一名52岁复发性抑郁症男性患者的病例，在剂量增加至300毫克/天后出现了安非他酮诱发的精神病发作。他出现了被害妄想，尽管他没有精神病病史或相关因素。随着安非他酮的停用和利培酮的加用，患者的精神病症状在一周内得到缓解。该报告回顾了自20年前以来的最新文献，以及安非他酮的多巴胺能效应、其导致精神病的能力以及与此问题相关的危险因素。尽管没有指南，但在某些情况下，如利培酮等抗精神病药物在停用安非他酮后有助于逆转其诱发的精神病。
