帕罗西汀致持续性呃逆1例

Paroxetine-induced persistent hiccups:a case report

惊恐障碍患者在使用抗抑郁药时,可能会出现持续性呃逆,给患者带来严重痛苦。本文报道1例患有惊恐障碍的成年患者,接受了帕罗西汀、劳拉西泮和普萘洛尔治疗。住院第3天,帕罗西汀增加至30 mg/d,5 d后增加至40 mg/d,次日患者开始呃逆。将帕罗西汀剂量降至30 mg/d,同时予以氯丙嗪改善呃逆表现,4 d后患者呃逆停止。根据病情需要,将帕罗西汀剂量增加至40 mg/d,患者再次出现呃逆,但与首次发作相比,持续时间较短,且严重程度较轻。再次给予氯丙嗪对症治疗,呃逆症状持续24 h后不再出现。帕罗西汀维持在40 mg/d,直至出院未再出现呃逆。帕罗西汀可引起成人惊恐障碍患者急性给药期持续性呃逆,应引起关注。

Patients with panic disorder may experience persistent hiccups when using antidepressants,causing severe pain.This article reports a case of an adult patient with panic disorder who received treatment with paroxetine,lorazepam,and propranolol.On the third day of hospitalization,the dose of paroxetine for the patient was increased to 30 mg/d,and after 5 days,it was increased to 40 mg/d.The patient began hiccups the next day.The dose of paroxetine was decreased to 30 mg/d and chlorpromazine was administered to improve hiccup symptoms.After 4 days of treatment,the patient's hiccup stopped.According to the needs of disease condition,the dose of paroxetine was increased to 40 mg/d,and the patient experienced hiccups again,but the duration was shorter and the severity was milder compared to the first episode.Symptomatic treatment with chlorpromazine was given again,and the hiccup symptoms stopped after persisting for 24 hours.Paroxetine was maintained at 40 mg/d,and no hiccups occurred until discharge.Paroxetine can cause persistent hiccups during acute administration in adult patients with panic disorder,which should be taken seriously.