Ziprasidone-associated Hypomania in Schizophrenia

精神分裂症患者服用ziprasidone誘發輕躁

陳志倫(Chih-Lun Chen) ； 毛衛中(Wei-Chung Mao) ； 張傳佳(Chuan-Chia Chang) ； 夏一新(I-Shin Shiah)

《台灣精神醫學》 20卷1期 (2006/03) Pp. 76-80

https://doi.org/10.29478/TJP.200603.0009

摘要

目的：本文報告一位精神分裂症患者服用ziprasidone治療後發生輕躁。個案報告：一位三十七歲台灣男性，診斷為慢性合併急性發作精神分裂症之患者，住院期間接受ziprasidone（每日160mg）的治療。十天後，該患者出現輕躁症狀包括誇大愉悅情緒、誇張自信、睡眠慾求減少、說話過多、及活動量過高。經我們將其ziprasidone停掉，換成risperidone（每日6mg）後，他的輕躁症狀消失。但他的精神分裂病症狀包括被害妄想和幻聽，最後是靠olanzapine（每日20mg）治療下才穩定的。結論：本文個案與過去報告案例顯示以ziprasidone治療的精神分裂病患者，可能出現輕躁或躁症狀。

關鍵字

第二代抗精神病藥物 ； ziprasidone ； 輕躁症 ； 躁症

並列摘要

Objective: Previous studies suggest that ziprasidone may result in hypomania or mania. However, most reported cases involved patients with mood disorders and only two schizophrenic patients developed mania during ziprasidone treatment. We describe a Taiwanese patient with schizophrenia who developed hypomanic symptoms following ziprasidone therapy. Case Report: A 37-year-old Taiwanese man who was hospitalized due to acute exacerbation of chronic schizophrenia was treated with 160mg per day of ziprasidone. Ten days after starting ziprasidone therapy, he developed hypomanic symptoms including expansive and euphoric mood, inflated self-esteem, decreased sleep desire, overtalkativeness, and hyperactivity. His mood symptoms resolved after switching from ziprasidone to risperidone therapy. However, his schizophrenic symptoms including persecutory delusions and auditory hallucinations relapsed after the switch in treatment. Due to the relapse of schizophrenic symptoms, his risperidone treatment was changed to olanzapine (20mg/d) and his schizophrenic symptoms were stabilized 12 days afterwards. Conclusion: This case suggests the need for awareness that hypomania or mania may occur as a result of ziprasidone treatment in schizophrenic patients.

並列關鍵字

second generation antipsychotics ； ziprasidone ； hypomania ； mania

參考文獻

Stimmel GL,Gutierrez MA,Lee V(2002).Ziprasidone: an atypical antipsychotic drug for the treatment of schizophrenia.Clin Ther.24,21-37.

Nolan BP,Schulte JJ(2003).Mania associated with initiation of ziprasidone.J Clin Psychiatry.64,336.

Baldassano CF,Ballas C,Datto SM(2003).Ziprasidone-associated mania: a case series and review of the mechanism.Bipolar Disord.5,72-75.

Brieger P(2004).Hypomanic episodes after receiving ziprasidone: an unintended "on-off-on" course of treatment.J Clin Psychiatry.65,132-135.

Davis R,Risch SC(2002).Ziprasidone induction of hypomania in depression?.Am J Psychiatry.159,673-674.