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Treating Tardive Dyskinesia with Aripiprazole

Aripiprazole治療遲發性運動障礙

摘要


目的:本文報告一位雙相性情感疾患之患者因出現遲發陸運動障礙(TD),經使用aripiprazole治療後,發現有效改善症狀。個案報告:個案為48歲台灣男性,診斷為第一型雙相性情感疾患。經使用鋰鹽合併傳統型抗精神病藥物haloperidol治療15年左右,開始出現遲發性運動障礙。藥物轉換為第二代抗精神病藥物quetiapine後,症狀稍有改善。但TD症狀仍有持續,甚至有惡化情形。單一使用aripiprazole 10 mg/day後,TD症狀漸緩。結論:Aripiprazole因具有多巴胺部分到效劑效果,不會引起第二型多巴胺受體過度調節,推測可以藉由穩定多巴胺系統,防止TD惡化,除改善症狀外,進一步可能可以治療TD。

並列摘要


Objective: Tardive dyskinesia (TD) is a serious, potentially irreversible side-effect of the use of some antipsychotic medications for certain psychiatric patients. At time of writing, dopaminergic-receptor supersensitivity would appear to be the most-accepted hypothesis pertaining to the origin of this undesirable complication. Herein, we report on the case of a Taiwanese patient suffering from TD whose condition was improved with aripiprazole therapy. Case report: A 48-year-old Taiwanese man who was diagnosed as Bipolar I disorder had suffered from TD for several years after antipsychotic medication. This patient presented with persistent TD despite the treatment with atypical antipsychotic medication. Subsequent to aripiprazole having been administered to this patient, his TD improved substantially. Conclusion: This case suggests that aripiprazole's partial dopamine-agonist action may provide an alternative pharmacotherapy to the moreconventional means of treating TD.

參考文獻


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Sharma, A,Ramaswamy, S,Dewan, VK(2005).Resolution of ziprasidone-related tardive dyskinesia with switch to aripiprazole. Prim Care Companion.J Clin Psychiatry.7,36.

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