摘要:
A 56-year-old male patient with undifferentiated type of schizophrenia received one disintegrating tablet of aripiprazole 10 mg orally once daily and the dose of the drug was increased to 30 mg once daily on day 21. Thereafter,the patient′s mental symptoms improved markedly. After receiving aripiprazole for 4 months,the patient developed difficulty in walking. Extrapyramidal symptoms (EPS) induced by aripiprazole was considered. The drug dose was reduced to 25 mg once daily,but the symptoms did not improve,subsequently,hypermyotonia,dysphagia,salivation,mask face,and urinary incontinence appeared. Although the dose of aripirazole was reduced to 5 mg once daily,it did not help to control EPS. Aripirazole was stopped,and 3 days later,the patient′s EPS became aggravated. Intravenous infusions of 0.9% sodium chloride injection 500 ml,Ⅳ vitamin C 2 g,Ⅳ vitamin B6 0.5 g as well as dextrose and sodium chloride injection 500 ml once daily were given to promote drug excretion. The next day,EPS relieved and on day 5,basically faded.%1例56岁男性患者因未分化型精神分裂症给予阿立哌唑口腔崩解片10 mg,1次/d.第21天增至30 mg、1次/d.此后患者精神症状明显好转.服药4个月后患者出现步行困难,考虑为阿立哌唑所致锥体外系症状(EPS).将该药剂量减至25 mg、1次/d,但患者症状无改善,并相继出现肌张力增高、吞咽困难、流涎、面具脸和遗尿等症状.虽然将阿立哌唑剂量减至5 mg、1次/d,但无助于EPS的控制.停用阿立哌唑.3 d后患者EPS加重,给予0.9%氯化钠注射液500 ml、维生素C 2 g、维生素B60.5 g及葡萄糖氯化钠注射液500 ml静脉滴注,以促进药物排泄.次日,患者EPS缓解;第5天,EPS基本消失.