Mashiko H, Yokoyama H, Matsumoto H, Niwa S
Department of Neuropsychiatry, Fukushima Medical College, Japan.
Psychiatry Clin Neurosci. 1996 Jun;50(3):133-6. doi: 10.1111/j.1440-1819.1996.tb01677.x.
A case of 19 year old male with hydrocephalus is reported whose aggressive self-injurious behaviors were resistant to conventional pharmacotherapy but successfully treated by trazodone. In addition to the self-injurious behaviors, this patient displayed withdrawal and eating refusal, which initially resulted in his admission to a psychiatric ward. Various conventional treatments with pharmacotherapy (e.g., tricyclic antidepressants, antipsychotics, anxiolytics and anticonvulsants) in combination with psychotherapy and family therapy proved not to be effective for 15 months. Neither was electroconvulsive therapy successful. Administration of trazodone for 5 months after tapering of the above agents improved his aggressive behaviors. A survey of previous cases with organic brain syndromes who had aggressive behaviors and responded well to trazodone revealed that most of the cases were aged individuals and that cases in adolescence are rare.
报告了一例19岁男性脑积水患者，其攻击性行为及自伤行为对传统药物治疗耐药，但曲唑酮治疗有效。除自伤行为外，该患者还表现出退缩和拒食，最初因此入住精神科病房。在15个月的时间里，各种传统药物治疗（如三环类抗抑郁药、抗精神病药、抗焦虑药和抗惊厥药）联合心理治疗和家庭治疗均未见效。电休克治疗也未成功。在逐渐停用上述药物后给予曲唑酮治疗5个月，改善了他的攻击性行为。对既往有器质性脑综合征且有攻击性行为并对曲唑酮反应良好的病例调查显示，大多数病例为老年人，青少年病例罕见。
