喹硫平与唑吡坦联用致抗精神病药恶性综合征

1例55岁女性患者,因行为异常、躁动、失眠等症状给予喹硫平0.2g,1次/d口服;唑吡坦5mg,每晚睡前服。用药9d后出现吞咽困难、多汗,随后逐渐出现言语不利,偶处于谵妄状态,双手不自主抽动,四肢肌张力增高。T38℃,BP171/87mmHg。实验室检查：WBC24.2×109/L,CK22820U/L,CK-MB225U/L,肌红蛋白1790U/L,LDH2565U/L。停用喹硫平及唑吡坦,纠正电解质紊乱,行保肝、营养支持治疗,应用血液透析。第10天患者症状明显改善,共住院36d出院。

Neuroleptic malignant syndrome due to combination therapy with quetiapine and zolpidem

A 55-year-old woman received quetiapine 0. 2 g once daily and zolpidem 5 mg at bedtime for abnormal behavior, agitation,and insomnia. After 9 days of treatment,the patient developed dysphagia,polyhydrosis,followed by gradual dysphasia, occasional delirium state,involuntary convulsion of both hands and hypermyotonia in extremities. Her temperature was 38℃ and blood pressure was 171 /87 mm Hg. Laboratory tests revealed the following values： WBC count 24. 2 × 109 /L,CK 22 820 U/L,CK-MB 225 U/L,myoglobin 1 790 U/L,LDH 2 565 U/L. Quetiapine and zolpidem were discontinued the electrolyte abnormalities were corrected,and she received liver-protective treatment,supportive therapy with nutrition,and hemodialysis. On day 10,the symptoms relieved obviously. And she was discharged after 36 days of hospitalization.