Paliperidone Use in a Patient of Wilson's Disease with Complex Psychiatric Presentations and Liver Cirrhosis

Paliperidone用於治療一位有複雜精神症狀的Wilson's disease患者

黃湘雄(Hsiang-Hsiung Huang) ； 張正辰(Cheng-Chen Chang)

《童綜合醫學雜誌》 10卷1期 (2016/06) Pp. 32-35

摘要

威爾森氏症（Wilson's disease, WD）是一種較少見因身體對銅的代謝異常而導致的遺傳性疾病，其主要臨床表徵為肝臟病變與神經精神症狀。對於合併有神經精神症狀與肝臟問題的威爾森氏症患者的治療，目前尚未有專門的臨床指引。傳統抗精神病藥物（conventional antipsychotics）由於會出現錐體外徑副作用（extrapyramidal adverse reactions），一般較不考慮將之用於威爾森氏症患者身上，因而，非典型抗精神病藥物（atypical antipsychotics）應該是一種較佳的選擇。

關鍵字

威爾森氏症 ； 神經精神症狀 ； 非典型抗精神病藥物

並列摘要

Wilson's disease (WD) is a rare genetic disorder of copper metabolism, which is characterized by hepatic and neuropsychiatric disease. There is no specific guideline regarding the treatment of neuropsychiatric symptoms in WD and liver disease. Conventional antipsychotics are not considered in patients with WD because of extrapyramidal adverse reactions, therefore atypical antipsychotics are more preferred. We report a case of a patient with WD with complex psychiatric presentations and liver cirrhosis in whom the psychiatric symptoms were successfully controlled using paliperidone, an atypical antipsychotic with minimal hepatic metabolism.

並列關鍵字

Wilson's disease ； neuropsychiatric presentation ； paliperidone ； atypical antipsychotics ； liver cirrhosis