Steroid psychosis in a polyarteritis nodosa patient successfully treated with risperidone tracking serum brain-derived neurotrophic factor levels longitudinally 英文参考文献.docVIP

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Steroid psychosis in a polyarteritis nodosa patient successfully treated with risperidone tracking serum brain-derived neurotrophic factor levels longitudinally 英文参考文献.doc

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Steroid psychosis in a polyarteritis nodosa patient successfully treated with risperidone tracking serum brain-derived neurotrophic factor levels longitudinally 英文参考文献

Yoshimuraetal.AnnalsofGeneralPsychiatry2012,11:2 /content/11/1/2 CASE REPORT OpenAccess Steroidpsychosisinapolyarteritisnodosapatient successfullytreatedwithrisperidone:tracking serumbrain-derivedneurotrophicfactorlevels longitudinally ReijiYoshimura1*,KosukeSaito1,TadanoriTerada2,NaokiYunoue3,WakakoUmene-Nakano1,ShintaroHirata3, KazuyoshiSaitoh3,YoshiyaTanaka3andJunNakamura1 Abstract Wepreviouslyreportedacaseinwhichsteroid-inducedpsychosiswaseliminatedwithrisperidonetreatmentina patientwithpolyarteritisnodosa(PN).Inthepresentreport,welongitudinallytrackedtheserumlevelsofbrain- derivedneurotrophicfactor(BDNF).WefoundthatcorticosteroidloweredserumBDNFlevels,andimprovementof psychiatricsymptomswasintactwiththeserumBDNFlevelsseeninthepatients. Introduction angiography (MRA). She had been treated with steroid There are several reports demonstrating the effective- pulse therapy (intravenous administration of methyl- ness of risperidone in treating steroid psychosis [1,2]. prednisoloneat45mg/day)followedbybetamethasone Wehavealsopreviously demonstrated that risperidone at 4 mg/day. After 1 month at this dosage, she had didnotchangeserumbrain-derivedneurotrophicfactor experienced a mixed state that included being more (BDNF)levelsinpatientswithschizophrenia[3].BDNF talkative than usual, feeling hyperactive, and excited, isassociatedwithpsychiatricdiseasessuchasdepression crying,feelingdepressed,andhavingrapidmoodswings, or schizophrenia [1]. In the present case, risperidone persecutory delusions, andauditory hallucinations. Her rapidly diminished our patient’s psychiatric symptoms score on the Brief Psychiatric Rating Scale (BPRS) was withoutsevereadverseeffects.Corticosteroidssuppress 33 points. Risperidone was started at 1 mg/day and BDNFlevelsinthebrain,whichleadstoatrophyofthe increased to2 mg/day, and the dose of betamethasone hippocampus [4]. Tothebestofourknowledge, this is was continued at the same dose (4 mg/day). Her psy- the firs