富马酸喹硫平致肌张力障碍

1例16岁女性患者因精神分裂症口服富马酸喹硫平,起始剂量100 mg,晚间1次,逐渐加量,至用药第40天增至600 mg/d(200 mg日间1次4,00 mg晚间1次)。当天患者出现不自主摇头和眨眼症状。其症状考虑与富马酸喹硫平相关,为此将其剂量减至400 mg,晚间1次。第3天患者发展为急性肌张力障碍。立即停用富马酸喹硫平,改为口服奥氮平,同时肌内注射丁溴东莨菪碱0.3 mg,静脉滴注5%葡萄糖注射液500 ml及葡萄糖氯化钠注射液1000 ml。第2天患者肌张力障碍症状消失。

Dystonia from use of quetiapine fumarate

A 16-year-old woman with schizophrenia received the initial dose of quetiapine fumarate was 100 mg every night,this dosage was gradually increased,until the dosage reached 600 mg/d（200 mg at daytime,400 mg at night） on day 40 of treatment.The same day,the patient developed involuntary head shaking and blinking.Her symptoms were considered to be associated with quetiapine fumarate,therefore the drug dosage was reduced to 400 mg at night.On day 3,the patient progressed to acute dystonia.Quetiapine fumarate was discontinued immediately and switched to oral olanzapine.Meanwhile,she received an IM scopolamine butylbromide 0.3 mg,an IV infusion of 5% glucose 500 ml and an IV infusion of glucose and sodium chloride 1000 ml.The next day,her dystonia symptoms disappeared.