Marshall R D, Douglas C J
New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, NY 10032.
Gen Hosp Psychiatry. 1994 Sep;16(5):358-60. doi: 10.1016/0163-8343(94)90024-8.
Phenylpropanolamine (PPA) is a sympathomimetic drug contained in numerous over-the-counter and prescription decongestants and appetite suppressants. A range of adverse effects have been reported, including neuropsychiatric reactions in patients known to be taking recommended doses. Given that psychiatric symptoms are not included in the manufacturer's lists of adverse drug reactions, the incidence may be significantly higher. We report a cae of paranoid psychosis following use of a decongestant containing PPA and summarize the case report literature of psychiatric adverse effects to PPA in which doses were known and stated to be within recommended guidelines. A pattern of possible risk factors emerges from these reports. These may include 1) symptoms or history of mood spectrum disorder, 2) history of psychosis, 3) female sex, 4) family history of psychiatric disorder. The possibility that a higher incidence of adverse events occurs in a vulnerable population has not been systematically addressed, and seems called for. We recommend that physicians specifically inquire about patients' use of decongestants and diet aids. In half of the above cases, symptoms resolved without the use of antipsychotics.
苯丙醇胺（PPA）是一种拟交感神经药物，存在于众多非处方和处方减充血剂及食欲抑制剂中。已报告了一系列不良反应，包括已知服用推荐剂量的患者出现神经精神反应。鉴于精神症状未包含在药品制造商的药品不良反应列表中，其发生率可能显著更高。我们报告了一例使用含PPA的减充血剂后出现偏执性精神病的病例，并总结了已知剂量且据称在推荐指南范围内的PPA精神不良反应的病例报告文献。这些报告中出现了一系列可能的风险因素。这些因素可能包括：1）情绪谱系障碍的症状或病史；2）精神病病史；3）女性；4）精神障碍家族史。尚未系统地探讨在脆弱人群中不良事件发生率较高的可能性，但这似乎是有必要的。我们建议医生特别询问患者使用减充血剂和减肥药的情况。在上述一半的病例中，症状在未使用抗精神病药物的情况下得到缓解。
