PDF(Pubmed)
Abstract：
Schizophrenia spectrum disorders are psychiatric conditions associated with an increased risk of all-cause mortality; patients with these conditions have a shortened average lifespan compared to the general population. First-line treatment for schizophrenia spectrum illness consists of atypical antipsychotics, which are associated with well-understood side effects, including metabolic syndrome, anticholinergic effects, and extrapyramidal symptoms. We are presenting a case of a 36-year-old patient treated with the atypical antipsychotic risperidone who experienced treatment-associated urinary incontinence. In the current literature, atypical antipsychotic-induced urinary incontinence is not well-documented in patients with schizophrenia spectrum disorder. Incontinence is often a topic of societal shame for many patients, and as a side effect, it may influence medication compliance. In the treatment of schizophrenia spectrum disorders, compliance is essential to prevent psychosis relapse in patients, so prescribers must be aware of this potential side effect and how to manage it. Upon a patient presenting with incontinence suspected to be due to atypical antipsychotics, other more common causes of incontinence must first be ruled out. Then, further management can consist of stopping the offending medication or adding a medication to address the incontinence. In this case, our patient had an extended history of suboptimal treated schizoaffective disorder, and risperidone was providing significant improvement; therefore, to ensure continued improvement, we initiated oxybutynin to manage urinary incontinence.
摘要：
精神分裂症谱系障碍是与全因死亡风险增加相关的精神疾病;与普通人群相比,患有这些病症的患者的平均寿命缩短。精神分裂症谱系疾病的一线治疗包括非典型抗精神病药，与众所周知的副作用有关，包括代谢综合征,抗胆碱能作用，锥体外系症状.我们正在介绍一例接受非典型抗精神病药物利培酮治疗的36岁患者，该患者经历了与治疗相关的尿失禁。在目前的文献中,非典型抗精神病药物引起的尿失禁在精神分裂症谱系障碍患者中没有得到很好的证明.对于许多患者来说，失禁通常是社会耻辱的话题，作为副作用，它可能会影响药物的依从性。在精神分裂症谱系障碍的治疗中，依从性对于防止患者精神病复发至关重要，所以开处方者必须意识到这种潜在的副作用以及如何管理它。当患者出现怀疑是由于非典型抗精神病药物引起的失禁时，必须首先排除其他更常见的尿失禁原因。然后，进一步的管理可以包括停止有问题的药物或添加药物以解决失禁。在这种情况下,我们的病人有长期治疗欠佳的分裂情感障碍病史，利培酮提供了显著的改善；因此，为了确保持续改进，我们开始使用奥昔布宁治疗尿失禁.
