Acute Dystonia after the Administration of Aripiprazole at a Subtherapeutic Dose in A Neuroleptic-Naive Psychotic Patient: A case Report and Literature Review

一位從未接受抗精神病劑治療的精神病人服用低於建議治療劑量的大塚安立復後產生急性肌張力不全：個案報告及文獻回顧

謝明翰(Ming-Han Hsieh)

《童綜合醫學雜誌》 13卷1期 (2019/06) Pp. 43-47

https://doi.org/10.3966/207135922019061301009

摘要

Background and purpose: To report a case of acute dystonia developed after treatment with aripiprazole at a subtherapeutic dose Methods: A 34-year-old neuroleptic-naive man with new-onset psychosis developed acute dystonia after undergoing treatment with aripiprazole at a subtherapeutic dose (7.5 mg/day). Results: In most cases, acute dystonia developed with 10-30 mg/day of aripiprazole. Herein, we report the first case of acute dystonia caused by aripiprazole administration at a subtherapeutic dose, i.e., 7.5 mg/day; the patient was a 34-year-old neuroleptic-naive man with new-onset psychosis. Further, we provide an updated literature review on aripiprazole-associated acute dystonia. Discussion: This case highlights the need for the awareness of clinicians about acute dystonic reaction in patients treated with aripiprazole at a subtherapeutic dose, although this dose is known for its low propensity to develop extrapyramidal syndrome.

關鍵字

Antipsychotics ； Aripiprazole ； Acute dystonia

並列摘要

背景及目的：報告一案例在使用低於建議治療劑量下之抗精神病劑大塚安立復（aripiprazole）後發生急性肌張力不全（acute dystonia）。方法：一位34歲第一次精神病發病之男性，使用低於建議治療劑量下之抗精神病劑大塚安立復7.5mg/d後發生急性肌張力不全。結果：大部分急性肌張力不全的個案都是發生在大塚安立復的建議治療劑量下10－30 mg/day。此處，我們報告了第一位在使用低於建議治療劑量下之抗精神病劑大塚安立復7.5 mg/day後發生急性肌張力不全的34歲男性且第一次發病及從未使用過抗精神病劑。我們同時提供了和大塚安立復相關之最新急性肌張力不全的文獻回顧。討論：本案例提醒臨床工作者要特別注意，即使大塚安立復發生錐體外症候群的機會較低，但在建議治療劑量以下仍可能發生。

並列關鍵字

抗精神病劑 ； 大塚安立復 ； 急性肌張力不全