Dhanabalan Arvind, Saveen Sall, Singh Christina, Ramasamy Ramona, Raveendran Keerthiga
Department of Medicine and Surgery, All Saints University School of Medicine, Roseau, DMA.
Department of Psychiatry, Louisiana State University Health Sciences Center, Shreveport, USA.
Cureus. 2024 Dec 1;16(12):e74915. doi: 10.7759/cureus.74915. eCollection 2024 Dec.
This article presents the case of a 67-year-old African American male patient who was referred to a psychiatry clinic by his Internal Medicine Provider with a diagnosis of "schizophrenia, unspecified." The patient reported the onset of auditory and visual hallucinations (AVHs) two years ago, coinciding with his starting Norco (hydrocodone 5 mg/acetaminophen 325 mg) for chronic back pain. He noted that his AVH worsened when he increased his prescribed Norco dosage (within his prescribed recommended range) and observed that the hallucinations ceased when he discontinued the medication. This case highlights the potential for opioid-induced AVH to be misdiagnosed as schizophrenia while emphasizing the importance of careful evaluation of opioid use in psychiatric assessments.
本文介绍了一名67岁非裔美国男性患者的病例，该患者被其内科医生转诊至精神科诊所，诊断为“未特定型精神分裂症”。患者报告称，两年前开始出现听觉和视觉幻觉（AVH），当时他开始服用诺科（氢可酮5毫克/对乙酰氨基酚325毫克）治疗慢性背痛。他指出，当他增加诺科的处方剂量（在规定的推荐范围内）时，AVH会恶化，并观察到停药后幻觉就会停止。该病例突出了阿片类药物诱发的AVH被误诊为精神分裂症的可能性，同时强调了在精神科评估中仔细评估阿片类药物使用情况的重要性。
