Treatment of refractory catatonic schizophrenia with low dose aripiprazole 英文参考文献.docVIP

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Treatment of refractory catatonic schizophrenia with low dose aripiprazole 英文参考文献.doc

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Treatment of refractory catatonic schizophrenia with low dose aripiprazole 英文参考文献

Sasakietal.AnnalsofGeneralPsychiatry2012,11:12 /content/11/1/12 CASE REPORT OpenAccess Treatmentofrefractorycatatonicschizophrenia withlowdosearipiprazole TsuyoshiSasaki1,2*,TasukuHashimoto2,TomihisaNiitsu3,NobuhisaKanahara2andMasaomiIyo1,2 Abstract Thiscaseisof54-year-oldfemalewithcatatonicschizophrenia,characterizedbytreatmentresistancetothe pharmacotherapywitholanzapine,risperidone,flunitrazepam,andECT.Olanzapineandrisperidoneand flunitrazepamdidnotimprovehercatatonicandpsychoticsymptoms,andinducedtheextrapyramidalsymptoms. TheeffectsofECTdidnotcontinueevenforamonth.However,thetreatmentwithlow-dosearipiprazole dramaticallyimprovedthepatient’spsychoticsymptomsandextrapyramidalsymptoms.Themechanisms underlyingtheeffectsoflow-dosearipiprazoleinthiscaseremainunclear,butunlikeotherantipsychotics, aripiprazoleisadopamineD2partialagonist.Inthisregard,ourresultssuggestthataripiprazolehasnumerous advantages,especiallyincasesofstuporouscatatoniaandadefectivegeneralstatus. Background schizophrenia. She was prescribed risperidone 1 mg/day Catatonia,whichischaracterizedbymotoricimmobilitysuch and flunitrazepam 1 mg/day for approximately 4 months, ascatalepsyorstupor,mutism,negativism,isshowninabout butherwithdrawalandstuporstatedidnotimprove,and 10-15%ofpatientswithschizophrenia[1].Publishedworks shewasreferredtoanotherhospitalat55yearsofage.No to date demonstrate variable treatment with benzodiaze- abnormalitieswerefoundinhergenerallaboratoryexami- pines,electroconvulsivetherapy(ECT),N-Methyl-D-Asparte nationsorbrainCT.Shereportedhavingconsistentpatho- (NMDA) antagonists,and antipsychotics, even the atypical, logical experiences, such as hallucination and delusions, whichremaindiscussed,becauseofworseninginsymptom- andherdiagnosiswasconfirmedascatatonic-typeschizo- atologyandincreasingtheriskofinducingneurolepticmalig- phreniaaccordingtotheDSM-IVcriteria.Wediscontinued nantsymdrome[2-4].Aripiprazole,adopamineD2receptor her previous medicatio