| 英文摘要 |
Nitroglycerin is a vasodilator due to the action of nitric oxide. It is also known as an N-methyl-D-aspartate (NMDA) receptor antagonist. NMDA receptor which play important rôles in learning and memory, is an ionotropic receptor mediating glutamate, a major excitatory neurotransmitter of the brain. Both mechanisms can produce analgesic effects. Here, we are presenting a case of a patient who had nitroglycerin abuse, showed catatonia after stopping of nitroglycerin abruptly. Mr. A, a 33-year-old previous heroin and alcohol use patient had stopped both substances for more than one year. He did not have any other major psychiatric and systemic disease. He had injected himself with fl unitrazepam (2 mg/time) and nitroglycerin intravenously without medical advice in an attempt to manage chronic pain due to a left femur shaft fracture for one year. He up-titrated nitroglycerin from 0.6 to 3.6 mg/day in a year to relieve pain without overt cardiovascular symptoms. His injection of nitroglyercin was on the first day of admission for pneumonia, but his consciousness level was gradually worsen on eighth day of admission despite the infection was improved. He showed symptoms of mutism, grimacing, stereotypy, and negativism without autonomic hyperactivity, hand tremor, or psychomotor agitation. |
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