拉莫三嗪增效治疗伴有躯体变形症状的精神分裂症1例

Lamotrigine augmentation in the treatment of schizophrenia with body dysmorphic symptoms:a case report

躯体变形症状是强迫相关障碍的一种症状,也可以作为精神分裂症的症状之一,给患者带来严重的痛苦和社会功能损害。躯体变形障碍(body dysmorphic disorder,BDD)的一线治疗药物是选择性5-羟色胺再摄取抑制剂(selective serotonin reuptake inhibitors,SSRIs),当患者治疗效果不佳,SSRIs联合各种辅助药物治疗是其常用策略。本文报道1例伴有躯体变形症状的精神分裂症青年女性患者经拉莫三嗪增效治疗有效的个案,并结合文献对躯体变形障碍临床特征、药物治疗及拉莫三嗪可能的作用机制和不良反应等进行讨论,以期为临床医生治疗躯体变形症状提供新的思路。

Body dysmorphic symptom is a symptom of obsessive-compulsive-related disorder and can be one of the symptoms of schizophrenia,causing severe distress and impairment of social functioning.Selective serotonin reuptake inhibitors(SSRIs)are the first line of therapeutic agents for body dysmorphic disorder(BDD).The combination of SSRIs and adjuvant drug therapy is a commonly used strategy for patients when their treatment is ineffective.This article reported a case of a young female patient with schizophrenia accompanied by body dysmorphic symptoms who was effectively treated with lamotrigine augmentation therapy,and discussed the clinical features of BDD,pharmacotherapy,potential pharmacological effects and adverse effects of lamotrigine based on the literature,in order to provide new perspectives on the treatment of body dysmorphic symptoms for clinical staff.