Visual and auditory hallucinations with excessive intake of paroxetine
Visual and auditory hallucinations with excessive intake of paroxetine
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过量摄入帕罗西汀会出现幻视和幻听
DOI：
10.1046/j.1440-1819.2003.01163.x
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发表时间：
2003
影响因子：
11.9
通讯作者：
H. Arai
中科院分区：
文献类型：
--
作者：
R. Kumagai;T. Ohnuma;T. Nagata;H. Arai
帕罗西汀是一种选择性5-羟色胺再摄取抑制剂（SSRI），由于其副作用少，作为一种有效和安全的治疗方法而受到欢迎。然而，研究人员报告了一些精神方面的副作用，包括在SSRI治疗期间出现幻觉的器质性因素病例。1-5在这里，我们报告的病人没有器质性因素，谁有幻觉，由于过度使用帕罗西汀。患者是一名28岁的日本女性，根据精神疾病诊断与统计手册（第4版; DSM-IV）标准诊断为分离性障碍，自25岁起出现分离症状。这些症状一个月只出现一两次，其他症状，特别是幻觉，从未出现过，因此她没有去医院。该患者在27岁时经历了复杂的恐慌发作，并在医院接受治疗，并被处方帕罗西汀，剂量调整为每日20-40 mg，持续数月。患者开始期待帕罗西汀对她的恐慌症状有更大的作用，并自行将剂量增加至每天120 mg。在自我处方增加帕罗西汀1个月后，她出现幻觉，包括看到一个男人坐在空座位上，听到婴儿的哭声，在工作时听到音乐而没有混乱。她的医生停止了她的帕罗西汀治疗。4天后，患者无法控制自己的脾气并出现幻觉，被收住Juntendo越谷医院。医疗检查，包括头部计算机断层扫描、胸部X光检查、心电图、全血细胞计数、肝脏、肾脏和甲状腺功能检查以及尿液分析，均未显示异常。脑电图显示没有意识障碍的迹象。生命体征正常。给予少量神经抑制剂（舒托必利; 150 mg/天）治疗她的幻觉和脾气。舒托必利给药后12天（帕罗西汀治疗停止后16天），症状消失。此后，患者从未出现幻觉，抗精神病药改为苯二氮卓类。表1。通过B y SS R I R效率，提供艾德c（已修复）的半导体绝缘体艾德c
Paroxetine, a selective serotonin re-uptake inhibitor (SSRI), has gained popularity as an effective and safe treatment because it produces few side-effects. However, investigators have reported several psychiatric side-effects, including cases with organic factors in which hallucinations were experienced during treatment with a SSRI. 1–5 Here, we report on a patient without organic factors, who had hallucinations due to excessive use of paroxetine. The patient was a 28-year-old Japanese woman diagnosed with dissociative disorder according to Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria and has experienced symptoms of dissociation since she was 25 years of age. These symptoms only appeared once or twice a month and other symptoms, specifically hallucinations, were never seen, and hence she did not attend a hospital. The patient experienced a complicated panic attack when she was 27 years old, and was treated at hospital and was prescribed paroxetine, with dose adjustments of 20–40 mg daily for a few months. The patient came to expect more of an effect from the paroxetine for her panic symptoms and increased the dose up to 120 mg per day by herself. After 1 month of the self-prescribed increase of paroxetine, she experienced hallucinations, which included seeing a man sitting in a vacant seat, hearing a baby’s cry and hearing music while working without confusion. Her doctor discontinued her treatment with paroxetine. After 4 days the patient was unable to control her temper and experienced hallucinations and was admitted to Juntendo Koshigaya Hospital. A medical work-up, including computed tomography of the head, chest X-rays, electrocardiogram, complete blood count, liver, renal and thyroid function tests, and urine analysis showed no abnormalities. Electroencephalography showed no evidence of consciousness disorder. Vital signs were normal. A small amount of neuroleptics (sultopride; 150 mg/day) were given to treat her hallucinations and temper. Twelve days after the administration of sultopride (16 days from the time paroxetine treatment was discontinued), the symptoms disappeared. Since then, the patient has never experienced hallucinations and the neuroleptic was switched to benzodiazepine. Ta bl e 1. P re vi ou sl y re po rt ed c as es o f ha llu ci na ti on s el ic it ed b y SS R I R ef er en ce s