scholarly journals Possible pharmacogenetic factors in clozapine treatment failure: a case report

2021 ◽  
Vol 11 ◽  
pp. 204512532110308
Author(s):  
Eromona Whiskey ◽  
Graziella Romano ◽  
Matilda Elliott ◽  
Malcolm Campbell ◽  
Cholan Anandarajah ◽  
...  
Keyword(s):  
Case Report ◽  
Treatment Failure ◽  
Psychotic Disorders ◽  
Therapeutic Response ◽  
Psychotic Symptoms ◽  
Therapeutic Drug ◽  
Biological Mechanisms ◽  
Evidence Based Treatment ◽  
Clozapine Treatment ◽  
Patients Experience

There is still much to learn about the predictors of therapeutic response in psychiatry, but progress is gradually being made and precision psychiatry is an exciting and emerging subspeciality in this field. This is critically important in the treatment of refractory psychotic disorders, where clozapine is the only evidence-based treatment but only about half the patients experience an adequate response. In this case report, we explore the possible biological mechanisms underlying treatment failure and discuss possible ways of improving clinical outcomes. Further work is required to fully understand why some patients fail to respond to the most effective treatment in refractory schizophrenia. Therapeutic drug monitoring together with early pharmacogenetic testing may offer a path for some patients with refractory psychotic symptoms unresponsive to clozapine treatment.

Treatment of psychosis during pregnancy – a case report and a mini-review

2011 ◽  
Vol 23 (5) ◽  
pp. 210-214 ◽  
Author(s):  
René E. Nielsen
Keyword(s):  
Case Report ◽  
Stress Disorder ◽  
Current Data ◽  
Current Evidence ◽  
Psychotic Symptoms ◽  
Clozapine Treatment ◽  
The Common ◽  
Emotionally Unstable Personality Disorder ◽  
Efficacy Profile ◽  
Clinical Problems

Nielsen RE. Treatment of psychosis during pregnancy – a case report and a mini-review.Objective: Describe clinical problems in treating a patient with psychotic symptoms during pregnancy by presenting a case report, and review the current evidence on antipsychotic drugs during pregnancy.Methods: The review consists of a non-systematic clinical review of current data on treatment with antipsychotics during pregnancy. The case, a 27 year old female initially diagnosed with posttraumatic stress disorder (PTSD) after a rape and emotionally unstable personality disorder, illustrates some of the common challenges a clinician meets. The patient initially discontinues all treatment as she is unsure if the drugs could have a teratogenic effect and is changed to a treatment that is regarded as safe during pregnancy.Results: The current data supports treatment with chlorpromazine although there is a risk of side effects, e.g. extrapyramidal symptoms and hypotension, but also treatment with olanzapine and risperidone. If the patient is currently treated with clozapine, this treatment should be continued, due to clozapines unique efficacy profile. Blood monitoring for six months after birth is recommended when the newborn has been exposed to clozapine treatment.Conclusion: Current evidence on treatment with antipsychotics during pregnancy is sparse, but not treating is associated with increased risks compared to treatment.

scholarly journals Dissociative Amnesia with Dissociative Fugue and Psychosis: a Case Report from a 25-Year-Old Ethiopian Woman

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Liyew Agenagnew ◽  
Elias Tesfaye ◽  
Selamawit Alemayehu ◽  
Mathewos Masane ◽  
Tilahun Bete ◽  
...  
Keyword(s):  
Case Report ◽  
Psychotic Disorders ◽  
Traumatic Event ◽  
Auditory Hallucination ◽  
Signs And Symptoms ◽  
Clinical Findings ◽  
Therapeutic Interventions ◽  
Psychotic Symptoms ◽  
Dissociative Amnesia ◽  
Scientific World

Introduction. The case after exposure to intense traumatic events manifests signs and symptoms of dissociative amnesia with a dissociative fugue and schizophrenia. The psychotic symptoms we found, in this case, were very complicated and mimicking primary psychotic disorders. Therefore, this might be a good forum for the scientific world to learn from this case report, how psychotic disorders coexist with dissociative disorders, since the literatures in this area are too rare. Main Symptoms and/or Important Clinical Findings. This case report focuses on the case of dissociative amnesia with dissociative fugue and psychosis in a 25-year-old Ethiopian female who lost her husband and three children at the same time during the nearby ethnic conflict. Associated with amnesia, she lost entire autobiographical information, and she also had psychotic symptoms like delusions and auditory hallucination which is related to the traumatic event she faced. The Main Diagnoses, Therapeutic Interventions, and Outcomes. The diagnosis of dissociative amnesia with a dissociative fugue comorbid with schizophrenia was made, and both pharmacological and psychological interventions were given to the patient. After the intervention, the patient had a slight improvement regarding psychotic symptoms but her memory problem was not restored. Conclusions. The observation in this case report brings to the fore that individuals with dissociative amnesia with dissociative fugue can have psychotic symptoms, and it takes a longer time to recover from memory disturbances.

scholarly journals Lorazepam-Resistant Catatonia in an Antipsychotic-Naïve 24-Year-Old with Psychotic Symptoms

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Juan Pablo Lucchelli ◽  
Stamatia Kourakou ◽  
Laia Pérez de Lucia Bové ◽  
Daniel Diaz Rodriguez
Keyword(s):  
Psychotic Disorders ◽  
Clinical Syndrome ◽  
Psychotic Symptoms ◽  
Consensus Guidelines ◽  
Clozapine Treatment ◽  
Dsm 5 ◽  
Diagnostic Hypothesis ◽  
Psychomotor Symptoms ◽  
Catatonic Syndrome ◽  
Underlying Pathology

Catatonia is a complex identifiable clinical syndrome characterized primarily by psychomotor symptoms. In recent decades, some authors have considered that catatonia can be presented as a catatonic syndrome in several pathologies such as bipolar disorder, schizophrenia and other psychotic disorders and not only in schizophrenia. Prior to DSM 5, there were two conceptions of catatonia: one in which clinical characterization seemed to play a determining role (a categorical view) and another in which a dimensional perspective advocated the existence of catatonia as a clinical entity in its own right, detached from the underlying pathology. Although there are no definitive consensus guidelines for the treatment of catatonia, some studies show that in the schizophrenic form of catatonia, benzodiazepines are partially effective, as well as treatment with ECT. We present the case of a 24-year-old man with severe catatonia and psychotic symptoms, resistant to lorazepam treatment, who achieved complete remission with clozapine treatment according to our diagnostic hypothesis of schizophrenia.

scholarly journals Assessment and treatment of individuals at high risk for psychosis

2019 ◽  
Vol 25 (3) ◽  
pp. 177-184 ◽  
Author(s):  
Christina Andreou ◽  
Barbara Bailey ◽  
Stefan Borgwardt
Keyword(s):  
High Risk ◽  
Psychotic Disorders ◽  
Treatment Options ◽  
Signs And Symptoms ◽  
Psychotic Symptoms ◽  
List Type ◽  
Evidence Based Treatment ◽  
The Past ◽  
Psychosis Risk ◽  
Assessment And Treatment

SUMMARYEarly detection and specialised early intervention for people at high risk for psychotic disorders have received growing attention in the past few decades, with the aim of delaying or preventing the outbreak of explicit psychotic symptoms and improving functional outcomes. This article summarises criteria for a diagnosis of high psychosis risk, the implications for such a diagnosis and recommendations for treatment.LEARNING OBJECTIVESAfter reading this article you will be able to: •recognise signs and symptoms indicating increased psychosis risk•understand uses and limitations of screening for high psychosis risk, and interpretation of results•recognise evidence-based treatment options for patients at clinical high risk for psychosis.DECLARATION OF INTERESTC.A. has received non-financial support from Sunovion and Lundbeck in the past 36 months.

scholarly journals Eating disorders and psychosis: a review and case report

2020 ◽  
Vol 66 (12) ◽  
pp. 1736-1741
Author(s):  
Rita Almeida Leite ◽  
Tiago Santos ◽  
Patrícia Nunes ◽  
Isabel Brandão
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Case Report ◽  
Psychotic Disorders ◽  
Family Background ◽  
Clinical Status ◽  
Psychotic Symptoms ◽  
Mesh Terms ◽  
Pubmed Database

SUMMARY INTRODUCTION: The interplay between eating disorders and psychosis is a challenging field to which little attention has been paid. Its study raises conceptual and methodological questions in both areas, making the diagnosis and management of patients difficult. Such questions are addressed and illustrated with a review and case report. METHODS: The authors present the case of a woman with Anorexia Nervosa and with comorbid Shared Psychotic Disorder, based on a literature review regarding the comorbidity between eating disorders and psychosis. The authors conducted a non-systematic review by searching the PubMed database, using the Mesh Terms “anorexia nervosa”, “bulimia nervosa”, “comorbidity” and “psychotic disorders”. RESULTS: The findings suggest that studies on the subject are limited by issues regarding data on the prevalence of comorbidities, phenomenological aspects of eating disorders, and the interface and integration with psychotic symptoms. CONCLUSIONS: The case presented illustrates the difficulties in managing a patient with a comorbid eating disorder and psychosis. In order to ensure a rigorous assessment of both psychotic and eating disorder symptoms, the focus should be on the pattern of appearance or emergence of symptoms, their phenomenology, clinical and family background of the patient, and clinical status on follow-up.

Clozapine treatment and post-traumatic psychotic disorders: A case report

1999 ◽  
Vol 9 ◽  
pp. 257-258 ◽  
Author(s):  
A. Laddomada ◽  
M.L. La Croce ◽  
M.M. Paluello ◽  
L. Serri ◽  
A.C. Altamura
Keyword(s):  
Case Report ◽  
Psychotic Disorders ◽  
Clozapine Treatment ◽  
Post Traumatic

Acute psychotic symptoms caused by overlapping central nervous system pathologies: a case report

2020 ◽  
pp. 376-379
Author(s):  
Gorkem Ugurlu ◽  
Mustafa Ugurlu ◽  
Meltem Kilic ◽  
Zuhal Apaydin ◽  
Ali Caykoylu
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Psychotic Symptoms

Gayet-Wernicke encephalopathy with rapid evolution toward dementia in alcoholic dependence – case report

Psihiatru ro ◽  
2019 ◽  
Vol 58 (3) (1) ◽  
pp. 18-20
Author(s):  
Cătălina Crişan ◽  
Laura Grosu ◽  
Oana Vanţa
Keyword(s):  
Case Report ◽  
Thiamine Deficiency ◽  
Withdrawal Syndrome ◽  
Rapid Evolution ◽  
Full Recovery ◽  
Wernicke Encephalopathy ◽  
Korsakoff Syndrome ◽  
Dementia Syndrome ◽  
Patients Experience

Gayet-Wernicke encephalopathy is an acute neuropsychiatric condition caused by thiamine deficiency. Only a small percentage of patients experience all three symptoms, with ophtalmoplegia, ataxia and confusion, and the full triad occurs more frequently among those who have overused alcohol. The evolution is toward full recovery, Korsakoff syndrome, dementia or death. We present the case of a 56-year-old patient, known with a diagnostic of alcoholism, who was admitted for a complicated withdrawal syndrome with delirium and who developed encephalopathy and dementia syndrome.

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