1例罕见的奥美拉唑致精神异常、幻视的案例分析

A rare case report of mental abnormality and visual hallucination induced by omeprazole

1例86岁老年男性,因咳痰喘息加重1周入院。先后给予抗感染、化痰、抑酸、营养支持等治疗。住院期间患者咳嗽减轻,无咳痰,气短喘息改善。之后患者突然出现情绪不稳定、烦躁、胡言乱语。医生排除疾病因素,临床药师积极询问患者病史及用药史,查看用药情况,结合药品说明书和文献资料,考虑患者出现精神异常、幻视与长期使用奥美拉唑有关,建议停用该药,其它药物继续使用。停药后患者精神异常、幻视症状改善,之后加用奥氮平,患者精神异常消失。停用奥氮平片,患者精神症状良好。之后未再使用奥美拉唑,患者无精神异常出现。

One 86-year-old man was admitted to the hospital with expectoration and dyspnea for 1 week. The patient was treated with anti-infection, reducing phlegm, acid suppression and nutritional support. During hospitalization, the symptom of cough and dyspnea improved, and there was no symptom of expectoration any more. The patient suddenly appeared unstable emotion, dysphoria and gibberish. Doctor ruled out disease factors, the clinical pharmacists actively asked the medical history and medication history of this patient, and checked the medication. Combined with drug instructions and literature, clinical pharmacists considered the mental abnormality and visual hallucination were associated with long-term use of omeprazole, and suggested stopping the drug. Then omeprazole was stopped, while the patient continued to use other drugs. The mental abnormality and visual hallucination were improved after stopping omeprazole. The mental abnormality disappeared after use of olanzapine. Three days later, olanzapine was discontinued, and the patient had a good mental condition. After that, omeprazole was not used, and the patient did not appear the mental abnormality.