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題名 | Olanzapine治療後病患受孕:一例報告=Pregnancy in a Patient Treated with Olanzapine: A Case Report |
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作者 | 曾獻德; 蔡世仁; | 書刊名 | 臺灣精神醫學 |
卷期 | 14:3 2000.09[民89.09] |
頁次 | 頁82-86 |
分類號 | 418.21 |
關鍵詞 | 抗精神藥物; 泌乳激素; 懷孕; Antipsychotics; Prolactin; Pregnancy; Olanzapine; |
語文 | 中文(Chinese) |
中文摘要 | 目的:傳統抗精神藥物因阻斷多巴胺第二受體,引起泌乳激素昇高而抑制女性病 患排卵及受孕機會。部份新型抗精神藥物如clozapine或olanzapine並無上述副作用,故女 性患者在改服這些藥後可能增加受孕機會。病例報告:本文報告一位已婚女性病患,在服用 sulpiride及risperidone後,仍持續有性生活且未避孕狀況下,亦未曾懷孕。在改用 olanzapine後恢復月經,並於三個月後懷孕。病患於民國八十九年五月廿三日順利產下女嬰 ,目前胎兒健康狀況良好。結論:目前新型抗精神藥物陸續推出,這些藥大多不會造成泌乳 激素的昇高,故不影響受孕。而這些藥物對胎兒的影響仍不清楚,故若女性患者從傳統抗精 神藥物改用新型抗精神藥物,可能因受孕機會增加而造成懷孕,臨床醫師對此類患者需注意 衛教,懷孕的檢查及藥物的調整。 |
英文摘要 | Objective: Traditional antipsychotic medication induces hyperprolactinemia, which can result in amenorrhoea and anovulation in female patients. Olanzapine, an atypical antipsychotic with minimal dopaminergic blocking, does not elevate prolactin levels, allowing resolution of antipsych- otic-induced hyperprolactinemia. As menstruation and more consistent ovulation resumes, the chance of pregnancy is increased. Case Report: The authors describe a married female patient with schizophrenia suffering menstrual cycls disturbances. Despite being sexually active without contraceptive use, she had not conceived while taking sulpiride or risperidone. She became pregnant within three months of switching from sulpiride and risperidone to olanzapine. Conclusion: Atypical antipsychotic treatment may increase the likelihood of planned and unplanned pregnancy with resolution of the hyperolactinemia induced previously by traditional antipsychotics. Clinicians must therefore keep in mind the effects of antipsychotic medication on fertility and educate patients about potential changes in reproductive fitness. The introduction of atypical antipsychotics has increased the importance of contraceptive counseling for mentally ill patients. (Full Text in Chinese) |
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