A case of severe parkinsonism associated with short-term treatment with milnacipran.
A case of severe parkinsonism associated with short-term treatment with milnacipran.
复制标题
与米那普仑短期治疗相关的严重帕金森病病例。
DOI：
10.1097/wnf.0b013e31815947c7
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发表时间：
2008
影响因子：
1
通讯作者：
S. Yamada
中科院分区：
文献类型：
--
作者：
T. Muraoka;Eisaku Oku;K. Sugataka;S. Yamada
一名51岁的妇女在她岳父去世后变得抑郁。她每天服用50毫克米那普仑。开始服用米那普仑一周后，她出现了帕金森症。米那普仑剂量增加至100 mg/d，导致患者帕金森综合征和抑郁症状恶化，这与125 I-间碘苄胍（MIBG）摄取减少有关。随后在她的药物中加入了300毫克左旋多巴和30毫克卡比多巴。然而，她的症状仍然持续了两个多星期。然后米那普仑逐渐减少，她被给予氟伏沙明与左旋多巴加卡比多巴。在开始氟伏沙明治疗方案后1个月内，帕金森症和抑郁症逐渐改善。MIBG摄取也在2个月内恢复（心肺比，2.1）。据我们所知，这是第二例报告的与使用血清素去甲肾上腺素再吸收抑制剂相关的帕金森症病例。该病例显示与帕金森综合征和抑郁症相关的MIBG摄取一过性减少。临床医生应该意识到，血清素去甲肾上腺素再摄取抑制剂以及选择性血清素再摄取抑制剂可以引起帕金森症。
A 51-year-old woman became depressed following the death of her father-in-law. She was given 50 mg of milnacipran a day. One week after starting milnacipran, she developed parkinsonism. The milnacipran was increased to 100 mg/d, resulting in a situation where her symptoms of parkinsonism and depression worsened, which was associated with the reduction of 125I-meta-iodobenzylguanidine (MIBG) uptake. Three hundred milligrams of levodopa plus 30 mg of carbidopa was subsequently added to her medications. However, her symptoms still continued for 2 more weeks. Then the milnacipran was tapered, and she was given fluvoxamine with levodopa plus carbidopa. The parkinsonism and the depression gradually improved within 1 month after starting the regimen of fluvoxamine. The MIBG uptake also recovered (Heart to Lung ratio, 2.1) within 2 months. To our knowledge, this is the second reported case of parkinsonism associated with the use of serotonin noradrenaline reuptake inhibitor. This case showed a transient reduction of MIBG uptake associated with the parkinsonism and depression. Clinicians should be aware that serotonin noradrenaline reuptake inhibitors as well as selective serotonin reuptake inhibitors can cause parkinsonism.