@article{oai:aino.repo.nii.ac.jp:02000003,
 author = {八尾,正之},
 journal = {藍野大学紀要, Bulletin of Aino University},
 month = {Aug},
 note = {幻覚妄想を呈して入院加療となった50歳(初回入院時)女性の統合失調症患者である.怠薬,拒薬傾向が強かったために,事前に内服薬にて目立った副作用等がないことを確認して持効性注射薬による抗精神病薬投与となった.しかしその後にアカシジアが出現し,徐々に増悪傾向となった.抗精神病薬を中止後もアカシジアは改善せず,希死念慮まで出現する事態となった.問診などの結果,長期間飲尿を継続していたことが判明し,尿中に排泄された薬剤が再吸収されて想定を超える薬物血中濃度になり,その結果としてアカシジアを生じたものと推測された.アカシジアによる疲労も強く入院加療となったが,入院中に単純ヘルペス脳炎を発症して他院へ転院となった.単純ヘルペス脳炎軽快後に抗NMDA受容体脳炎を生じたが,リハビリを終えて再度当院へ入院となった.脳炎の後遺症は重く,現在も口唇傾向などのKluver-Bucy症候群の部分症状が残存している.精神科治療においては飲尿などの特殊な行動に留意する必要性を感じた症例であった.(著者抄録), A 50- year- old female patient, diagnosed with schizophrenia, was firstly admitted for the treatment of psychiatric symptoms including hallucinations, delusions, and agitation. Since she frequently denied and refused oral treatments, a long- acting injectable antipsychotic drug was started after no significant adverse side- effects of similar oral treatment had been confirmed.While taking the series of injections, the symptoms of akathisia appeared and gradually became worse. The akathisia did not resolve even after all antipsychotic drugs were discontinued and the patient began to present with complaints of suicidal ideation. The results of the interviews revealed that the patient had been drinking her own urine for a long period of time. The increased and persisted blood drug concentration due to reabsorption of drugs from drinking urine seemed to trigger akathisia. While the patient had been hospitalized for the treatments of schizophrenia and akathisia, herpes simplex encephalitis occurred and she was soon transferred to another general hospital. Although herpes simplex encephalitis became less severe, anti-NMDA receptor encephalitis occurred. After the rehabilitation ended, the patient was readmitted to our hospital. The patient still suffered from severe sequelae of encephalitis and oral tendency, a major symptom of Klüver- Bucy syndrome. This case showed the need to pay attention to strange behaviors such as drinking urine in psychiatric treatment.},
 pages = {1--7},
 title = {持効性注射薬:paliperidone palmitate使用中に重症アカシジアを併発したのち稀有な経過を辿った統合失調症の一例},
 volume = {35},
 year = {2023}
}