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40例抗精神病药治疗致死及猝死病案分析 被引量:9

An analysis of 40 psyckiatric patients who died during antipsychotic drug treatment.
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摘要 分析了我院28年来在抗精神病药治疗中,因严重毒副作用致死(30例)和原因不明猝死(10例)的病案。发现药源性忧郁自杀和过度镇静致死的病案都发生在1980年以前(P<0.01)。出现各种临床危象后,24小时内死亡率以抗精神病药治疗致死者和淬死者为高(P<0.001).出现毒副作用症状或猝死发生当日,抗精神病药氯丙嗪等效日量的中位数均在750mg及以上;但氯氮平单一治疗中猝死的5例,都是在剂量不大(氯丙嗪等效日量中位数375mg)的情况下发生的。 AbstractObjective:To study the causes of death of patients during antipsychotics treatment.Method:Thirtypatients who died of severe or toxic side effects of antipsychotics and 10 patients who died suddenly dur-ing antipsychotic treatment within a period of 28 years were analyzed by reviewing their case records.Results:All cases of suicide due to drug-induced depression and deaths due to oversedation occurredbefore 1980.The 24-hour death rate was.much higher in patients who developed clinical crisis thanthose who died of other causes. The median chlorpromazine equivalent during the day when toxic sideeffects or sudden death occurred was 750mg/day. However,the dosage was not high in the 5 subjectswho were treated with clozapine alone(median chlorpromazine equivalent was 375mg/day).Discussion:Apart from the sudden deaths where causes were unclear,there were 8 kinds of severe toxic and side ef-fects of antipsychotics which would account for the death cause. Sudden deaths with unclear causes in-creased after 1980.It was reported that sudden death was often caused by arrhythmia and conductionblocks induced by antipsychotics,so more attention should bLi paid to them. Doctors should be morecareful in using clozapine as toxic side effects were often related to overdosage.
机构地区 苏州市广济医院
出处 《临床精神医学杂志》 1995年第5期281-283,共3页 Journal of Clinical Psychiatry
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