三環系抗うつ剤Ａｍｏｘａｐｉｎｅによる悪性症候群とおもわれる１例

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  • A case of malignant syndrome due to amoxapine, a triple-ring antidepressant.

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The case was a 42-year-old male patient, who was diagnosed as having melancholia with deprressed mood, psychomotor retardation, feeling of fretfulness, insomnia, and dysorexia. Those symptoms improved at about 4 weeks after administration of antidepressant drugs (sulpride and amoxapine), an antianxiety drug (etizolam), and hypnotic drugs (nitrazepam and haloxazolam). However, approximately 4 months later, the depressive condition re-appeared. Thus, 225mg/day of initial dose of amoxapine was administered with gradual increase in dose every two weeks. About 2 weeks later, the patient showed a sudden disturbance of consciousness, muscle rigidity, and perspiration, leading to emergency hospitalization. At admission, examinations demonstrated of consciousness, muscle rigidity, perspiration, fever (38.3°C), tachycardia (126/min), abnormal blood pressure (170/100), increase of leukocytes (12800/mm3), and elevated CPK (1327 IU/l), which aroused suspicion of the malignant syndrome. Accordingly, subsequent suspension of antidepressive drugs and administration of adjuvant fluid led to rapid improvement of the disturbance of consciousness, muscle rigidity, perspiration, tachycardia, and abnormal blood pressure. The leukocytosis normalized about 4 days later, the fever about 7 days later, and the elevated CPK about 9 days later. Cases of malignant syndrome due to amoxapine have rarely been reported.

収録刊行物

  • 医療

    医療 44 (10), 1078-1082, 1990

    一般社団法人 国立医療学会

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