查詢結果分析
相關文獻
頁籤選單縮合
題 名 | 精神分裂症患者服用Clozapine出現強迫症狀:二例報告=Clozapine-induced Obsessive-compulsive Symptoms in Patients with Schizophrenia: Report of Two Cases |
---|---|
作 者 | 蘇聖棻; 劉士愷; 蔡長哲; 林世光; 陳俊澤; 林式穀; | 書刊名 | 臺灣精神醫學 |
卷 期 | 14:2 2000.06[民89.06] |
頁 次 | 頁62-70 |
分類號 | 418.21 |
關鍵詞 | 精神分裂症; 強迫症狀; Schizophrenia; Clozapine; Obsessive-compulsive symptoms; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:報告二例精神分裂症患者服用clozapine,導致引發強迫症狀的治療過程並回顧文獻,討論其處理對策。 病例報告:個案一為為31歲男性精神分裂症患者,發病已有十一年,曾服用fluphenazine,精神病症狀仍持續,三個月前改服clozapine 300 mg/day,精神病症狀雖改善,但一個月前開始出現強迫思考 (看到男人就會一直想到其下體並想要去摸),個案因此焦慮不安,有自殺的意念,故住院治療。藥物最後調整為clozapine 250 mg/day 及sertraline 150 mg/day ,約一個月後強迫症狀已緩解。個案二為25歲男性精神分裂症患者,精神分裂症發病已有十年,服用過flupenthixol, clopenthixol, haloperidol,而精神病症狀仍持續,於六年八個月前開始服用clozapine 400 mg/day,並在二年八個月前增加至500 mg/day,精神病症狀尚穩定。本次住院之主訴為最近八個月以來出現重覆找人問同樣的問題,一直找人握手等強迫行為,其同事不堪其擾,故入院治療。住院後藥物調整多次,最後減少clozapine劑量至200 mg/day ,改服用risperidone 4 mg/day,併用sertraline 150 mg/day,住院五個月後精神病症狀改善,強迫症狀部份緩解。 結論:精神分裂症患者服用clozapine引發強迫症狀,若觀察二週強迫症狀仍未緩解或因精神病症狀導致減少clozapine劑量不可行,則可併用與clozapine 無交互作用之血清素再吸收抑制劑 (serotonin reuptake inhibitors, SRIs) 來治療。 |
英文摘要 | Objective: GMunchausen syndrome by proxy is characterized by a parent who attempts to deceive medical personnel into believing that her child is ill. The content of deception may include a feigned history of illness and the induction of illness in the child. Case report: GWe present the case of a 40-year-old mother who insisted her three sons had long term insomnia since they were 2 or 3 years old. These three children aged 12, 13 and 15 years were forced to receive many kinds of treatments including folk therapy, herb drugs and other unnecessary procedures. Although they were suffering from severe side effects of medications, these children cooperated with their mother and accepted the illness of insomnia. Based on the perceived negative effects and high risk of mortality, a series of physical examinations and psychodynamic interviews was arranged. After detailed evaluation, these illness behaviors met the criteria of factitious disorder in DSM-IV. Munchausen Syndrome by proxy was diagnosed. Individual psychotherapy and family therapy was given for one year. The case gradually accepted the treatments and maintained regular follow-up. Conclusion: GOur patient claimed that her children had insomnia as a symptom/sign for pluralistic help seeking. This illness history could be easily feigned. This case reminds us of the need to prevent child abuse and to provide protection for the children of patients with this disorder. |
本系統中英文摘要資訊取自各篇刊載內容。