多巴胺激动剂诱发帕金森病奥赛罗综合征1例报告。

Q4 Medicine
Case Reports in Psychiatry Pub Date : 2025-09-05 eCollection Date: 2025-01-01 DOI:10.1155/crps/8517387
Ghazi Uddin Ahmed, Haadi Uddin Ahmed, Ahmed Asad Raza, Abedin Samadi
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引用次数: 0

摘要

背景:奥赛罗综合症(OS)是一种罕见的精神障碍,其特征是妄想嫉妒和毫无根据的怀疑不忠。它与神经系统疾病如帕金森病(PD)有关,特别是在接受多巴胺激动剂(DAs)治疗的患者中。病例介绍:一名长期诊断为PD的69岁男性,由于不耐受而从左旋多巴/卡比多巴转向罗匹尼罗后出现OS。在开始使用罗匹尼罗6个月后,患者开始对妻子的忠诚产生强烈的妄想,尽管没有认知能力下降或精神病史。妄想症状使他的婚姻关系严重紧张。临床表现及诊断评估:神经学检查与PD相符,核磁共振(MRI)未见脑结构异常。罗匹尼罗使用与症状发作之间的时间相关性导致了罗匹尼罗诱发OS的诊断。罗匹尼罗在4周内逐渐停用,并引入喹硫平。患者的精神症状明显改善,妄想信念消除,配偶关系恢复。结论:该病例强调了da(包括罗匹尼罗)在PD患者中诱导OS的潜力。临床医生应在PD治疗过程中对精神病学副作用保持警惕,并考虑及时干预,包括药物调整和抗精神病治疗,以防止严重的社会心理后果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Othello Syndrome Induced by Dopamine Agonists in Parkinson's Disease: A Case Report.

Othello Syndrome Induced by Dopamine Agonists in Parkinson's Disease: A Case Report.

Background: Othello syndrome (OS) is a rare psychiatric disorder characterized by delusional jealousy and unfounded suspicions of infidelity. It has been associated with neurological diseases such as Parkinson's disease (PD), particularly in patients receiving dopamine agonists (DAs). Case Presentation: A 69-year-old man with a longstanding diagnosis of PD developed OS after transitioning from levodopa/carbidopa to ropinirole due to intolerance. Six months after initiating ropinirole, the patient began experiencing intense, delusional beliefs regarding his wife's fidelity, despite no cognitive decline or psychiatric history. The delusional symptoms significantly strained his marital relationship. Clinical Findings and Diagnostic Assessment: Neurological examination remained consistent with PD, and no structural brain abnormalities were observed on magnetic resonance imaging (MRI). The temporal association between ropinirole use and symptom onset led to the diagnosis of ropinirole-induced OS. Ropinirole was gradually discontinued over 4 weeks, and quetiapine was introduced. The patient showed substantial improvement in psychiatric symptoms with resolution of delusional beliefs and restoration of spousal rapport. Conclusion: This case highlights the potential for DAs, including ropinirole, to induce OS in PD patients. Clinicians should remain vigilant for psychiatric side effects during PD treatment and consider timely intervention, including medication adjustment and antipsychotic therapy, to prevent severe psychosocial consequences.

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来源期刊
Case Reports in Psychiatry
Case Reports in Psychiatry Medicine-Psychiatry and Mental Health
CiteScore
1.00
自引率
0.00%
发文量
49
审稿时长
12 weeks
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