Paliperidone使用在精神分裂症病人引起過度飲水症狀

Paliperidone-induced Polydipsia in Schizophrenia

目的： 慢性精神分裂症病人中，過度飲水是常見但易被忽略的現象，可能導致低血鈉、 癲癇和昏迷，甚至致死。第二代抗精神病藥物對過度飲水的影響，至今未有定論。我們報告 一位在接受 paliperidone 治療時，出現過度飲水的個案。 個案報告： 一名 37 歲男性慢性精神 分裂症病人，接受每天 paliperidone 12 mg 的治療。三週後，出現過度飲水（ 天喝水大於十 公升）、體重上升及低血鈉。在將 paliperidone 換成 olanzapine 每天 20 mg 兩週後，上述症狀 獲得改善，且半年內沒有復發上述症狀。 結論： Paliperidone 可能引起過度飲水，值得臨床醫療人員的研究及注意。

Objective: Polydipsia is an underdiagnosed clinical phenomenon among pa- tients with chronic schizophrenia. Detection and management of polydipsia are clinically important because of its complications such as severe hyponatremia and water intoxication, resulting in epilepsy, coma, and death. The effect of antipsy- chotic drugs can cause polydipsia remains controversial. Case Report: We report a 37-year-old male patient taking paliperidone (12 mg per day) for chronic schizo- phrenia. After a three-week treatment with paloperidone, he developed polydipsia (daily water intake being greater than 10 liters) and hyponatremia. He did not have any other medical causes. We switched paliperidone to olanzapine (20 mg per day) due to suspected paliperidone-induced polydipsia. His daily water intake was de- creased to 5 liters after two weeks, and all other associated symptoms were sub- sided. No relapse of polydipsia was noted in the following six months. Conclu-sion: Polydipsia may be related to paliperidone use. Further investigation of its cause relationship is needed.