統合失調症の徘徊行動にolanzapineとparoxetineの併用が著効した1例

Wandering Behavior in Schizophrenia Successfully Treated by Combined Therapy Using Olanzapine and Paroxetine：A case report

抄録

　徘徊行動を伴う統合失調症の治療に対し，olanzapineとparoxetineの併用が有効であった1例を報告する。統合失調症の陰性・陽性症状に対してはolanzapineが奏効したが，頑固な徘徊行動は残存していた。徘徊行動を強迫行為と考えparoxetineの追加投与を行ったところ，徘徊行動は著明に改善した。統合失調症に強迫性障害を伴うことは決して珍しいことではなく，最近では第二世代抗精神病薬とselective serotonin reuptake inhibitors(SSRI)との併用が有効であった症例が数多く報告されている。しかし徘徊行動に注目した報告は我々の知る限りなく，興味深い症例と考えられた。

　We encountered a case of schizophrenia　with wandering behavior that showed marked improvement due to combined therapy using olanzapine and paroxetine. Although negative and positive symptoms were improved by olanzapine monotherapy, wandering behavior remained. As the patient's wandering behavior was considered to be an obsessive-compulsive symptom, we added paroxetine. One week later his wandering behavior reduced both subjectively and objectively. On his discharge from hospital, his wandering behavior showed complete remission(Y-BOX score 22→0). It is not rare that schizophrenic patients also experience obsessive-compulsive symptoms, and recent literature shows that combined therapy using SSRIs and atypical antipsychotics are useful in such cases. To our knowledge, this is the first case report that focuses on wandering behavior in schizophrenia and its treatment.