Quetiapine Treatment for Polydipsia in a Schizophrenic Patient

Quetiapine治療精神分裂症病人之過度飲水症

吳俊毅(Chun-Yi Wu) ； 詹宏裕(Hung-Yu Chan) ； 張景瑞(Ching-Jui Chang) ； 陳快樂(Happy Kuy-Lok Tan) ； 孫效儒(Hsiao-Ju Sun)

《台灣精神醫學》 22卷3期 (2008/09) Pp. 231-235

https://doi.org/10.29478/TJP.200809.0008

摘要

目的：一位精神分裂症病人合併過度飲水，改服quetiapine後症狀緩解。病例報告：三十歲男性精神分裂症病人，服用傳統抗精神病藥物約十年，出現過度飲水症狀。因混亂行為合併過度飲水等問題住院接受治療，雖予限水及飲水衛教等非藥物治療，但過度飲水合併水中毒問題並未獲得改善。經過fluphenthixol 9~15mg/d 治療四週後，改以quetiapine 400mg/d治療，持續治療兩週後，過度飲水問題幾乎完全緩解，精神症狀則約於治療七週後改善，此後6個月追蹤期間並未再出現過度飲水現象，且精神症狀持續穩定。結論：Quetiapine具有多巴胺受體快速解離特性，可能不會造成D2接受器過度激化或過度飲水現象。顯示quetiapine為精神分裂症合併過度飲水病人可選擇之治療藥物。

關鍵字

Quetiapine ； 抗精神病藥物 ； 過度飲水 ； D2接受器過度激化

並列摘要

Objective: We report a case of chronic schizophrenia with polydipsia, which remitted after antipsychotic treatment was shifted to quetiapine. Case report: This 30-year-old schizophrenic man had a 10-year history of psychotic symptoms which were regularly treated with conventional antipsychotics. He was admitted to the acute ward due to disorganized behaviors and water intoxication. His condition had not improved despite nonpharmacological treatments including water restriction and drinking behavior education. After four weeks of non-responsiveness to fluphethixol (9-15mg/d) treatment, the medication was changed to quetiapine 400 mg/d. His polydipsia was almost completely remitted two weeks later. The patient did not have any relapse of polydipsia or psychotic symptoms during six months of follow-up. Discussion: Quetiapine is characterized by a fast dissociation mechanism and may not induce D2 receptor hypersensitivity or polydipsia. This suggests its suitability as a possible candidate for the treatment of schizophrenic patients with polydipsia.

並列關鍵字

quetiapine ； antipsychotic drug ； polydipsia ； D2 receptor hypersensitivity

參考文獻

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