Mirtazapine用於治療難治型病態性搔抓症

Mirtazapine for the Treatment of Drug-resistant Pathological Skin Picking

目的：病態性搔抓症 (PSP) 並非罕見疾病且已有一些藥物治療被提出。但適切的治療方 式仍是有限。在此報告一例用mirtazapine 成功治療難治型病態性搔抓症的個案。個案報告： 42 歲女性，有智能障礙，其病態性搔抓症病史已至少10 年以上，試過行為治療及各類藥 物，如抗憂鬱劑、topiramate 和lamotrigene，療效皆有限。在每日 30 mg 的mirtazapine 治療 一週後PSP 症狀明顯改善。結論：Mirtazapine 明顯改善這位病人的搔抓症狀，但仍需進一 步研究以證實其療效與作用機轉

Objective: Pathological skin-picking (PSP) is a common disorder, and some pharmocotherapies for PSP have been reported. But the appropriate treatment is limited. We are reporting the use of mirtazapine to successfully treat a refractory PSP case. Case Report: This 42-year-old woman patient with mental retardation had suffered from treatment-refractory PSP for at least ten years. She had received behavioral therapies and various pharmacologic agents, including several kinds of antidepressants, topiramate, and lamotrigene. But she had got only minimal improvement. After receiving mirtazapine 30 mg/day for one week, the patient’s PSP was dramatically improved. Conclusion: Mirtazapine showed to have improved PSP in this patient. More well-designed studies are needed to defi nitely prove the effect and neurobiologic actions of mirtazapine in PSP.