抗精神病药物所致药源性精神障碍40例分析

目的了解抗精神病药物所致药源性精神障碍的有关情况。方法回顾性分析40例药源性精神障碍患者用药类别、剂量、发病时间、精神状态、治疗及预后。结果绝大多数精神障碍发生在用药1~3个月内,以高效价含氟类药物及氯氮平最多。大中剂量用药、突然增减药量和停药及合并用药者易发生;女性、老年、合并躯体疾病者易发生。绝大多数患者经过减药、停药、或者换用其他抗精神病药物3~14d症状缓解或消失。结论抗精神病药物所致药源性精神障碍不可忽视,要注意与原发症状进行鉴别,在治疗过程中,应仔细观察,正确判断,合理用药,防止新的症状出现。发生机制可能与多巴胺受体有关。

Drug Psychosis by Antipsychotic Drugs:Report of 40 Cases

Objective To study drug psychosis induced antipsychotic drugs.Methods We analyzed retrospectively the classification,dosage,pathogenic time,mental status,treatment and prognosis in 40 cases.Results Most mental aberration occurred within 1-3 months,mainly caused by high-titer fluorine drugs and clozapine.It occurred possibly when big or middle dosage was given,dosage was increased or decreased unexpectedly,medication stopped and combined medication was given.It occurred more frequently in female and aged.The symptom relieved or disappeared within 3-14 days in most patients after drug deduction,drug withdrawal or use of other drugs.Conclusion We shouldn't ignore drug psychosis induced by antipsychotic drugs.We must distinguish it from primary symptom.Its genetic mechanism is related to dopamine receptor.