PDF(Pubmed)
Abstract：
Dimenhydrinate is an over-the-counter antihistaminergic medication with anticholinergic properties used to treat nausea or motion sickness worldwide. There is a well-established correlation between the use of anticholinergic medications and dementia, however, it is unclear if a causal role exists. We report a case of minor neurocognitive disorder in a woman in her 40s with several years of high-dose daily dimenhydrinate abuse who subsequently developed significant delusional beliefs. Her clinical presentation was confounded by numerous other factors that could have impacted her cognition, such as a longstanding presumed learning disability, ankylosing spondylitis with adalimumab treatment, extensive cannabis use or potential development of a primary psychotic disorder. Her workup was within normal limits, and she has not responded to first-line antipsychotic medications to date. This case report adds to the growing evidence supporting concerns about potentially irreversible cognitive deficits in chronic misuse of anticholinergic agents, an association previously observed only in the elderly population.
摘要：
dimoenhyrinate是一种具有抗胆碱能特性的非处方抗组胺药，用于治疗世界范围内的恶心或晕动病。抗胆碱能药物的使用与痴呆症之间存在着公认的相关性，然而,尚不清楚是否存在因果关系.我们报告了一名40多岁的女性患有轻度神经认知障碍的病例，该患者每天遭受高剂量的dimenhydrinate滥用，随后产生了明显的妄想信念。她的临床表现被许多其他可能影响她认知的因素所混淆，例如长期假定的学习障碍，强直性脊柱炎与阿达木单抗治疗，广泛使用大麻或潜在发展为原发性精神病。她的检查在正常范围内，迄今为止，她对一线抗精神病药物没有反应。该病例报告增加了越来越多的证据，支持对慢性误用抗胆碱能药物中潜在不可逆的认知缺陷的担忧。以前仅在老年人群中观察到的关联。
