Imipramine과 Amitriptyline에 依한 急性 腦症侯 및 幻視에 關한 症例 = Acute Brain Syndrome and Visual Hallucinations with Imipramine and Amitriptyline

다국어 초록 (Multilingual Abstract)

Recently, acute brain syndrome and visual hallucinations during imipramine and imipramine-like drugs administration have been reported and discussed by many.
However, the relationship between acute brain syndrome and visual halluchinations by imipramine and imipramine-like drugs has not been determined. Some reported visual hallucinations only, some acute brain syndrome and others visual hallucinations with acute brain syndrome.
We observed 2 cases of visual hallucinations with acute brain syndrome and I case of visual hallucinations without mental confusion.
In the 1st case, a man, aged 58, developed typical delirium with visual hallucinations after 16 days of treatment, culminating in 250mg of imipramine daily.
In the 2nd case, a man, aged 28, developed delirious syndrome with visual hallucinations after 33 days of treatment, culminating in 125mg of amitriptyline daily as well as E.S.T.
In both cases above mentioned, we administrated antiparkinsonian agent together.
In the 3rd case, a woman, aged 58, developed-vivid visual hallucinations without any disturbance of consciousness after 14 days of treatment, culminating in 150mg of amitriptyline daily.
In these 3 cases, the formal structure of visual hallucinations had various forms from simple ones such as blue sparkles and yellow stars etc. to complex ones with thing-quality such as crawling snake and mother etc.
The acute brain syndrome and visual hallucinations of these 3 cases were disappeared after gradually decreasing the daily dosage of imipramine and amitriptyline. The development of the acute brain syndrome and visual hallucinations had no correlation with the changes of the clinical pictures of underlying depression in all 3 cases.