Obesity facts · 2008
Psychosis following anti-obesity treatment with rimonabant.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Ugur Tarik, Bartels Marius, Kis Bernhard, Scherbaum Norbert
Аннотация
BACKGROUND: In this report, we present the case of a patient with a relapse of schizophrenia following an episode of depression and increased anxiety after antiobesity treatment with rimonabant, a cannabinoid type 1 receptor antagonist.
CASE REPORT: After 4 weeks of treatment the patient developed psychiatric symptoms, i.e. depressed mood and elevated anxiety. Four months after the discontinuation of rimonabant, the patient presented with psychotic symptoms fulfilling ICD-10 criteria of paranoid schizophrenia. Antipsychotic treatment with quetiapine was initialized. A stable recovery took further 4 weeks in which combined treatment with quetiapine and ziprasidone was given.
CONCLUSION: The course of the illness suggests that the continuous affective symptoms, which were most likely a side effect of rimonabant, may have triggered the psychosis analogous to the stress-diathesis model of schizophrenia. As a consequence, rimonabant may not be the first choice in obese patients with a history of schizophrenia due to a potentially increased risk of a relapse via an indirect mechanism.
CASE REPORT: After 4 weeks of treatment the patient developed psychiatric symptoms, i.e. depressed mood and elevated anxiety. Four months after the discontinuation of rimonabant, the patient presented with psychotic symptoms fulfilling ICD-10 criteria of paranoid schizophrenia. Antipsychotic treatment with quetiapine was initialized. A stable recovery took further 4 weeks in which combined treatment with quetiapine and ziprasidone was given.
CONCLUSION: The course of the illness suggests that the continuous affective symptoms, which were most likely a side effect of rimonabant, may have triggered the psychosis analogous to the stress-diathesis model of schizophrenia. As a consequence, rimonabant may not be the first choice in obese patients with a history of schizophrenia due to a potentially increased risk of a relapse via an indirect mechanism.