一名人类免疫缺陷病毒患者对利培酮和奥氮平的不同敏感性
Differential sensitivities to risperidone and olanzapine in a human immunodeficiency virus patient.
作者信息
Meyer J M, Marsh J, Simpson G
机构信息
USC Department of Psychiatry, Los Angeles County-USC Medical Center 90033, USA.
出版信息
Biol Psychiatry. 1998 Oct 15;44(8):791-4. doi: 10.1016/s0006-3223(97)00552-0.
BACKGROUND
Neuroleptic sensitivity presents a considerable problem for the treatment of psychosis in the acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV)-positive patient population. As yet, there are few data on the response of these patients to newer atypical antipsychotic medications.
METHODS
We present the detailed medication history of a 33-year-old man with AIDS, who had a prior history of extrapyramidal symptoms (EPS) with both typical antipsychotics and risperidone, and was treated with olanzapine for major depression with psychotic features.
RESULTS
The patient developed akathisia in a dose-dependent manner at dosages between 10 and 15 mg daily of olanzapine, but no EPS. Akathisia responded to dose reduction and use of beta-adrenergic blockade.
CONCLUSIONS
The AIDS patient may exhibit sensitivity even to newer atypical antipsychotics. The lack of EPS and response to a beta-blocker underscore the different mechanisms causing akathisia and EPS.
背景
在获得性免疫缺陷综合征（AIDS）患者和人类免疫缺陷病毒（HIV）阳性患者群体中，抗精神病药物敏感性给精神病治疗带来了相当大的问题。目前，关于这些患者对新型非典型抗精神病药物反应的数据很少。
方法
我们介绍了一名33岁艾滋病男性患者的详细用药史，该患者既往使用典型抗精神病药物和利培酮时均有锥体外系症状（EPS）病史，此次因伴有精神病性特征的重度抑郁症接受奥氮平治疗。
结果
患者在奥氮平每日剂量为10至15毫克时出现了剂量依赖性的静坐不能，但无EPS。静坐不能通过减少剂量和使用β-肾上腺素能阻滞剂得到缓解。
结论
AIDS患者甚至可能对新型非典型抗精神病药物表现出敏感性。缺乏EPS以及对β受体阻滞剂的反应突出了导致静坐不能和EPS的不同机制。
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