난폭하고 공격적인 행동을 보이는 치료저항성 정신분열병 환자의 Risperidone 장기 지속형 주사제를 이용한 치료 사례

A Case of Aggressive and Violent Patient with Treatment-Resistant Schizophrenia Treated with Long-Acting Injectable Risperidone

  본 증례는 치료저항성 정신분열병 환자의 폭력적이고, 공격적인 행동과 투약에 비협조로 인하여 적절한 치료가 어려운 경우에 risperidone 장기 지속형 주사제를 사용하여 증상을 완화시키고, 다른 경구용 항정신병약물의 효과를 증진시킬 수 있도록 하여, 환자의 증상 조절을 용이하게 해준 증례이다. 만성정신병원에서 적지 않게 치료 받고 있을 본 증례와 유사한 환자 뿐만 아니라, 여러 이유로 치료저항성 정신분열병 환자로 잘못 분류되어질 수 있는 환자들에게 본 치료 사례는 도움이 될 것이다.

  Aggressive and violent behaviors are an important problem in psychiatric department. Treatment-resistant schizophrenia with aggressive and violent behavior is more and more growing problem in treatment and management. A 45-year-old treatment-resistant schizophrenic male patient with aggressive and violent behavior was treated with long-acting injectable risperidone, added to previous antipsychotic medication. After adding long-acting injectable risperidone, his violent and aggressive behavior had been much improved. Patient’s poor drug compliance was also improved, which is associated with frequent seclusion or restraint, and sedation induced by antipsychotic injection. This case shows the benefit of long-acting injectable risperidone, for aggressive and violent schizophrenic patient with treatment-resistant feature. In addition, this case proposed that the difficulty of administering antipsychotics to uncooperative patients with any cause, such as none of insight for diseases or aggressive and violent behavior, is added to the definition of drug compliance or adherence.