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01 奈良県立医科大学 >
011 医学部 >
0112 紀要 >
01121 Journal of Nara Medical Association >
Vol.49 No.5 >
Please use this identifier to cite or link to this item:
http://hdl.handle.net/10564/475
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Title: | 精神分裂病に下垂体性巨人症を合併した1症例 : プロモクリプチン併用についての考察 |
Other Titles: | A CASE OF SCHIZOPHRENIA WITH PITUITARY GIGANTISM Ⅰ CONCOMITANT BROMOCRIPTINE THERAPY WITH NEUROLEPTICS |
Authors: | 森川, 将行 飯田, 順三 岸本, 年史 伊藤, 直人 畑, 和也 南, 尚希 中井, 貴 |
Keywords: | schizophrenia pituitary gigantism growth hormone bromperidol bromocrlptlne |
Issue Date: | 31-Oct-1998 |
Publisher: | 奈良医学会 |
Citation: | Journal of Nara Medical Association Vol.49 No.5 p.412-419 |
Abstract: | Bromocriptine is an ergot alkaloid derivative that possesses both dopamine
agonist and antagonist activity. This biphasic action has allowed bromocriptine to be used
for many psychiatric disorders. We describe a rare case of schizophrenia with pituitary
gigantism, whose psychiatric symptoms were improved by concomitant bromocriptine
therapy with neuroleptics. The patient (a 30-year-old single female) had been suffering
from schizophrenia during the past 12 years. In remission, she was employed in accounting.
At age 25, brain CT scanning revealed a pituitary tumor, but operation was not indicated.
At age 30, she discontinued neuroleptics by herself. As a result, she had a relapse and
entered a psychiatric hospital for the first time. Her psychiatric symptoms were auditory
hallucination, delusion of persecution, reference and control, and depersonalization.
Neurological symptoms were not present. Serum growth hormone ranged from 4 to 13.6
ng/ml (normal 0.6-3.7 ng/ml). Brain MRI scanning also revealed a pituitary tumor, of a
size less than 1 centimeter and localized in sella turcica. Bromperidol improved her
symptoms for the most part, but depersonalization continued obstinately. After a while, she
was started on bromocriptine 2.5mg daily together and increased gradually. At 7.5mg
daily her depersonalization began to be reduced and then at 15 mg daily it disappeared.
Through the course of treatment, there were no side effects of bromocriptine therapy.
Generally at low doses bromocriptine acts on the presynaptic autoreceptor as antagonist
activity, while at higher doses, bromocriptine works directly on the postsynaptic receptor
as agonist activity. However in this case the effective dose was a moderate dose, 15 mg
daily ; finally bromocriptine may act as antipsychotic action. Concomitant bromocriptine
therapy with neuroleptics were useful in schizophrenia with pituitary gigantism. |
URI: | http://hdl.handle.net/10564/475 |
ISSN: | 13450069 |
Appears in Collections: | Vol.49 No.5
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