P.230 Treatment-resistant psychotic symptoms in non-syndromic intellectual disability involving an interstitial deletion of 20q13.13

2020 ◽  
Vol 40 ◽  
pp. S129-S130 ◽  
Author(s):  
L. Ilzarbe ◽  
D. Ilzarbe ◽  
A. Sánchez ◽  
I. Baeza
Keyword(s):  
Intellectual Disability ◽  
Interstitial Deletion ◽  
Psychotic Symptoms ◽  
Treatment Resistant

scholarly journals High-dose olanzapine in treatment resistant schizophrenia. A case report and literature review

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S115-S115
Author(s):  
Ciara Clarke ◽  
Clodagh Rushe ◽  
Fintan Byrne
Keyword(s):  
Case Report ◽  
Literature Review ◽  
The Body ◽  
Psychotic Symptoms ◽  
High Dose ◽  
Extensive Literature ◽  
Treatment Resistant ◽  
Persecutory Delusions ◽  
Full Resolution ◽  
One Year

ObjectiveWe report a case of a 58-year-old gentleman who was hospitalised intermittently for one year due to treatment resistant schizophrenia. Prior to hospitalisation he had been prescribed standard antipsychotics for decades without full resolution of positive psychotic symptoms. During his final admission lasting six months he was guarded, suspicious, irritable, constantly paced the corridor and displayed thought block and paranoid persecutory delusions. He would not enter the assessment room or allow any blood or ECG monitoring, however, he was compliant with oral medication. He was successfully treated with high dose olanzapine (40mg/day) and was discharged to the community. The aim of this study is to bring awareness and add to the body of evidence for the use of high-dose olanzapine in patients with treatment resistant schizophrenia in whom a trial of clozapine is not possible.Case reportThe patient gave written consent for this case report to be written and presented. An extensive literature review was performed and key papers were identified. Discussion focuses on the key areas in the literature.DiscussionThis case demonstrates that high-dose olanzapine can be used effectively as an alternative to clozapine in treatment resistant schizophrenia.ConclusionThis case highlights the need for further evaluation of high-dose olanzapine as an alternative to clozapine in patients with treatment-resistant schizophrenia.

Clozapine Induced Rash: Case Report of Successful Desensitization

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
R. Singh ◽  
K. Raju ◽  
J. Southern ◽  
J. Darroch
Keyword(s):  
Side Effects ◽  
Drug Hypersensitivity ◽  
Effective Means ◽  
Drug Dose ◽  
Delayed Type Hypersensitivity ◽  
Psychotic Symptoms ◽  
Hypersensitivity Reactions ◽  
Treatment Resistant ◽  
Drug Of Choice ◽  
Cutaneous Hypersensitivity

Aim:Clozapine is the drug of choice for patients with treatment-resistant schizophrenia. However a minority of them have been unable to continue with Clozapine due to side-effects, for example rash. This report looks at the use of graded desensitization in a patient who developed cutaneous reactions to Clozapine.Method:This report describes the management of a patient with treatment resistant-schizophrenia, mild learning disabilities and epilepsy, following a cutaneous reaction to Clozapine. Having been maintained on Clopixol depot until 4 years ago, he required a change in antipsychotics following a relapse of psychotic symptoms. He was then treated unsuccessfully with various anti-psychotics, before starting Clozapine, to which he showed a good response. Unfortunately he developed an eczematous rash on two separate occasions when the drug was introduced. Again he was tried on other anti-psychotics, to which he also developed a rash. He was then put on a graded desensitization regimen of liquid Clozapine.Results:Graded desensitization, using incremental increases in drug dose, allowed maintenance treatment with therapeutic doses of Clozapine to be achieved in the absence of cutaneous hypersensitivity reactions. the patient's previously treatment-resistant psychotic symptoms were improved by this method.Conclusion:We should be aware of possibilities for the management of both the common and uncommon side-effects associated with Clozapine, as the result might vastly improve the patients’ quality of life. Desensitisation regimens can be an effective means of overcoming drug hypersensitivity but should be used with great caution, especially when patients exhibit delayed-type hypersensitivity reactions.

scholarly journals Treatment-resistant psychotic symptoms and the 15q11.2 BP1–BP2 (Burnside-Butler) deletion syndrome: case report and review of the literature

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Martilias Farrell ◽  
Maya Lichtenstein ◽  
Matthew K. Harner ◽  
James J. Crowley ◽  
Dawn M. Filmyer ◽  
...  
Keyword(s):  
Case Report ◽  
Deletion Syndrome ◽  
Psychotic Symptoms ◽  
Review Of The Literature ◽  
Treatment Resistant

scholarly journals An Interstitial Deletion at 7q33-36.1 in a Patient with Intellectual Disability, Significant Language Delay, and Severe Microcephaly

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Trupti Kale ◽  
Melissa Philip
Keyword(s):  
Intellectual Disability ◽  
Interstitial Deletion ◽  
Language Delay ◽  
Facial Features ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Phenotypic Profile ◽  
Concise Review ◽  
Phenotypic Variations ◽  
Primary Focus

Interstitial deletions of the distal 7q region are considered a rare entity. In this report, we describe a seven-year-old male with a heterozygous interstitial deletion at 7q33-36.1 with characteristic dysmorphic facial features, intellectual disability, severe microcephaly, and significant language delay. The primary focus of our report is to compare our case with the few others in the literature describing interstitial deletions at the long arm of chromosome 7. Based on the various breakpoints in prior studies, a number of phenotypic variations have been identified that are unique to each of the reports. However, there are also a number of similarities among these cases as well. We hope to provide a concise review of the literature and genes involved within our deletion sequence in the hope that it will contribute to creating a phenotypic profile for this patient population.

scholarly journals Successful rechallenge with paliperidone after clozapine treatment for a patient with dopamine supersensitivity psychosis

2020 ◽  
Vol 8 ◽  
pp. 2050313X2092956
Author(s):  
Remiko Kobayashi ◽  
Yasunori Oda ◽  
Ryunosuke Hayatsu ◽  
Nozomi Ohki ◽  
Misa Akutsu ◽  
...  
Keyword(s):  
Symptomatic Relief ◽  
Psychotic Symptoms ◽  
Psychotic Episode ◽  
Antipsychotic Treatment ◽  
Treatment Resistant ◽  
Clozapine Treatment ◽  
Clozapine Dose ◽  
Japanese Male ◽  
Old Japanese ◽  
Dopamine Supersensitivity

We describe the case of a 49-year-old Japanese male patient successfully treated with a paliperidone rechallenge following 2-year treatment with clozapine for treatment-resistant schizophrenia. He had responded well to conventional antipsychotic treatment for the initial psychotic episode but gradually developed dopamine supersensitivity; even treatment with paliperidone and another antipsychotic medication (a total up to 1700 mg in chlorpromazine-equivalent dose) had not improved his psychotic symptoms. Clozapine treatment produced temporary symptomatic relief, but the clozapine dose could not be increased to > 150 mg due to the patient’s intolerance. Following low-dose clozapine treatment for 2 years, a rechallenge with paliperidone monotherapy ameliorated his psychotic symptoms. This suggests that clozapine may have the potential to release the dopamine supersensitivity state. Our patient’s case indicates that for patients with dopamine supersensitivity psychosis, a rechallenge with a previously ineffective antipsychotic after clozapine treatment may be successful.

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