Watanabe H, Terao T
Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
J UOEH. 1997 Mar 1;19(1):29-38. doi: 10.7888/juoeh.19.29.
A depressed 36-year-old woman manifesting a delusion of persecution was started on neuroleptics. In parallel with the increase of neuroleptics, she suffered from akathisia, such as wandering, and thereafter developed neuroleptic malignant syndrome. Thus, neuroleptics were discontinued. As a result, she manifested severer wandering, impairment of conversation, and unacceptable behavior (e.g. touching her stool) though neuroleptic malignant syndrome subsided. These symptoms improved following the administration of levomepromazine and amitriptyline. It seems difficult to regard these symptoms as just a prolongation of akathisia, since the level and frequency of akathisia increased. It also seems unlikely to regard these symptoms as those of agitated depression, since there were no complaints of irritability. On the other hand, it seems probable that "withdrawal akathisia" occurred following the discontinuation of neuroleptics and the reinstituted levomepromazine improved the withdrawal phenomena consisting of severer wandering, impairment of conversation, and unacceptable behavior.
一名36岁患有被害妄想的抑郁症女性开始服用抗精神病药物。随着抗精神病药物剂量增加，她出现了静坐不能，如四处徘徊，此后发展为抗精神病药物恶性综合征。于是停用了抗精神病药物。结果，尽管抗精神病药物恶性综合征消退，但她出现了更严重的徘徊、交谈障碍和不可接受的行为（如触摸自己的粪便）。给予左美丙嗪和阿米替林后这些症状有所改善。由于静坐不能的程度和频率增加，似乎很难将这些症状仅仅视为静坐不能的延续。也不太可能将这些症状视为激越性抑郁，因为并无易激惹的主诉。另一方面，停用抗精神病药物后很可能发生了“撤药静坐不能”，重新使用左美丙嗪改善了由更严重的徘徊、交谈障碍和不可接受行为组成的撤药现象。
