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題名 | Treatment of L-dopa Induced Psychotic Symptoms Using Quetiapine=以Quetiapine治療L-dopa發之精神病性症狀 |
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作者 | 周孫元; 詹宏裕; 孫效儒; Chou, Sun-yuan; Chan, Hung-yu; Sun, Hsiao-ju; |
期刊 | 臺灣精神醫學 |
出版日期 | 20031200 |
卷期 | 17:4 2003.12[民92.12] |
頁次 | 頁311-317 |
分類號 | 418.2251 |
語文 | eng |
關鍵詞 | 帕金森氏症; L-dopa引致精神病; Parkinson's disease; L-dopa-induced psychosis; Quetiapine; Dopaminergic transmission; |
中文摘要 | 目的:報告一例帕金森氏症患者,可能因使用抗帕金森氏症藥物i-dopa 引致精神病,以quetiapine治療達到良好效果,並討論此類個案的治療對策。 病例報告:一位72歲女性帕金森氏症患者,3年前開始有帕金森氏症症狀及使用i-dopa治療,8個月前逐漸出現幻覺、妄想及幻覺行為,使用sulpiride 200 mg/d治療,雖然精神症狀迅速改善,帕金森氏症症狀卻加重而停用。但個案精神症狀迅速惡化而於半年前住院,住院改用quetiapine 50mg/d治療,約一個月後,精神症狀緩解且帕金森氏症狀並未惡化。 結論:i-dopa 引致精神病以低劑量quetiapine 治療,可改善精神症狀且避免惡化帕金森氏症。 |
英文摘要 | Objectives:Objective: There are emerging data showing the potential efficacy of atypical antipsychotic drugs in treating psychosis in patients with Parkinson's disease. We report a case of Parkinson's disease with psychotic symptoms that responded well to quetiapine without worsening of extrapyramidal symptoms. Case report: A 72-year-old woman had a three-year history of Parkinson's disease for which she received L-dopa treatment. 28 months after the start of treatment, psychotic symptoms including hallucinations, delusions and disorganized behaviors, began to emerge. The dose of L-dopa decreased, and sulpiride 200 mg/d was prescribed and psychotic symptoms subsided soon after. However, sulpiride had to be discontinued due to the exacerbation of the symptoms of Parkinson's disease. This led to flare up of the psychotic symptoms requiring admission to the acute psychiatric ward about two months later. Quetiapine 50 mg/d was prescribed and full remission of psychotic symptoms was noted one month after the initiation of treatment without exacerbation of Parkinson's disease. Conclusion: This case suggests that quetiapine may be an effective alternative in treating L-dopa-induced psychosis in patients with Parkinson's disease. |
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