Abstract:
Treatment with long-acting injection (LAI) antipsychotics, such as paliperidone palmitate, has improved the quality of life in terms of symptoms and prevention of relapses in patients with schizophrenia. Although there are plenty of evidences about the efficacy and safety of paliperidone palmitate 3-monthly injection (PP3M) in adults with schizophrenia, literature appears lacking about the use of LAIs during pregnancy. We hereby describe the clinical case of a pregnant woman affected by schizophrenia (DSM-5-TR), taking pharmacological treatment of PP3M. Considering the inadequate evidence regarding the use of PP3M in pregnancy in agreement with the patient, we switched PP3M to an oral therapy with aripiprazole. The switch to oral aripiprazole allowed the patient to improve her sense of autonomy and strengthen the therapeutic relationship. To our knowledge, this is the first case report monitoring an entire pregnancy of a women affected by schizophrenia in treatment with PP3M injection and oral aripiprazole. No obstetrical or fetal complications were reported. As the research in this field is very demanding, it would be precipitous to derive final conclusions from the current case report, but we hope to build a growing number of data that would allow us to make more appropriate and safe therapeutic choices in such a vulnerable phase as the peripartum.
摘要:
长效注射(LAI)抗精神病药物治疗,如帕潘立酮棕榈酸酯,改善了精神分裂症患者在症状和预防复发方面的生活质量。尽管有大量证据表明帕利哌酮棕榈酸酯3个月注射(PP3M)在精神分裂症患者中的疗效和安全性,有关怀孕期间使用LAI的文献似乎缺乏。我们在此描述患有精神分裂症(DSM-5-TR)的孕妇的临床病例,服用PP3M的药物治疗。考虑到与患者同意在妊娠期间使用PP3M的证据不足,我们将PP3M改为阿立哌唑口服治疗.改用口服阿立哌唑可以改善患者的自主性并加强治疗关系。据我们所知,这是首例监测一名精神分裂症患者接受PP3M注射液和口服阿立哌唑治疗的整个妊娠的病例报告.未报告产科或胎儿并发症。由于该领域的研究要求很高,从当前的病例报告中得出最终结论将是非常艰难的,但是我们希望建立越来越多的数据,使我们能够在诸如围产期这样的脆弱阶段做出更合适和安全的治疗选择。