维护还是移除?氯氮平治疗患者心包炎:关于一个病例

Q4 Medicine Psiquiatria Biologica Pub Date : 2021-09-01 DOI:10.1016/j.psiq.2021.100334
Rocío Paricio del Castillo, Pablo del Sol Calderón, Inmaculada Palanca Maresca
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引用次数: 1

摘要

氯氮平引起的心包炎是一种罕见但潜在的严重疾病,建议停止氯氮平治疗以解决。病例介绍:一位17岁的男性,由于之前三种抗精神病药物治疗失败而接受氯氮平治疗,治疗效果良好,在开始使用该药两个月后出现心包炎。氯氮平引起的心肌炎和心包炎是严重的不良反应,主要出现在治疗的第一个月。对氯氮平所致心包炎的普遍态度是停药。这种退出可能会造成道德困境,应仔细评估,因为应考虑到精神失代偿和生活质量损失的风险。结论本病例强调了在每个复杂病例中进行风险/收益平衡的重要性,反映了氯氮平不良反应管理的伦理冲突,因为它的停药可能会对患者的精神病理稳定性和生活质量产生负面影响。
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¿Mantenimiento o retirada? Pericarditis en un paciente en tratamiento con clozapina: a propósito de un caso

Introduction

Clozapine-induced pericarditis is a rare but potentially serious condition for which discontinuation of clozapine treatment is recommended for resolution.

Presentation of the case

A 17-year-old male under treatment with clozapine due to failure of three previous antipsychotic lines, with good therapeutic response, who two months after starting the drug developed pericarditis.

Discussion

Clozapine-induced myocarditis and pericarditis are serious adverse effects that appear mostly in the first month of treatment. The generalized attitude towards clozapine-induced pericarditis is its withdrawal. This withdrawal may pose an ethical dilemma and should be carefully assessed, as the risk of psychiatric decompensation and loss of quality of life should be taken into account.

Conclusion

This case highlights the importance of performing a risk/benefit balance in each complex case, reflecting the ethical conflict of the management of clozapine adverse effects, since its withdrawal may negatively compromise the patient's psychopathological stability and quality of life.

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来源期刊
Psiquiatria Biologica
Psiquiatria Biologica Medicine-Psychiatry and Mental Health
CiteScore
0.40
自引率
0.00%
发文量
13
期刊介绍: Es la Publicación Oficial de la Sociedad Española de Psiquiatría Biológica. Los recientes avances en el conocimiento de la bioquímica y de la fisiología cerebrales y el progreso en general en el campo de las neurociencias han abierto el camino al desarrollo de la psiquiatría biológica, fundada sobre bases anatomofisiológicas, más sólidas y científicas que la psiquiatría tradicional.
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