摘要
1病例简介
患者,女,18岁,因“猜疑、耳闻人语4月,加重1周,总病程7年”第2次住院。患者2003年3月起病,表现为猜疑被害,曾在当地医院住院,诊断精神分裂症,予以氯氮平治疗,最高剂量为125mg/d,用药后第4周出现粒细胞下降(白细胞2.7×10^9/L,中性粒细胞1.24×10^9/L),而自动出院。
This patient had antipsychotic-induced extrapyramidal symptoms and leucopenia. We use both psychiatric and neurological approaches to managing these side effects. We adopted the neurological approach to treating the extrapyramidal side-effects when the psychiatric approach proved ineffective. In addition, we found that prior leukopenia is a relative--but not absolute--contraindication for using clozapine: patients with a prior history of leukopenia (but not agranulocytosis) can be carefully re-challenged with clozapine while their blood counts are being closely monitored.
出处
《上海精神医学》
2011年第5期316-317,共2页
Shanghai Archives of Psychiatry