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Valentine MJ, Kayastha A, Newsome-Cuby TR, Nguyen ATN, Fisher RG, Pham HM, Meimon SA, Phu A, Parry CA, Nelson JJ, Hayes EC, Muranjan S. A Clinical Suspicion of Quetiapine-Induced Psychosis: A Case Report and Literature Review. Cureus 2024; 16:e52167. [PMID: 38347998 PMCID: PMC10859674 DOI: 10.7759/cureus.52167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
Quetiapine, a pharmacological agent within the class of atypical antipsychotics, is characterized by its efficacy in mood stabilization and its role in the modulation of serotonergic and dopaminergic pathways. Its therapeutic utility is broad, encompassing the management of acute psychotic episodes, schizophrenia, bipolar disorder, and treatment-resistant depressive states. Quetiapine's effectiveness extends to depressive disorders that do not exhibit classic psychotic features, with a side effect profile that is less burdensome than many alternative psychotropic medications. Its versatility in addressing a range of psychiatric conditions is useful in the psychopharmacological management of mood and thought disorders. However, like all drugs, quetiapine may have different effects relative to the individual. It is imperative to approach the administration of quetiapine carefully, ensuring any adverse effects are ameliorated for beneficial therapeutic outcomes. In this case report, we present a psychosis-naive 42-year-old male who developed psychotic symptoms after beginning a quetiapine regimen in order to manage major depressive disorder with suicidal ideation. Clinical suspicion of quetiapine-induced psychosis was a diagnosis considered due to symptom remission secondary to ziprasidone in the place of quetiapine. The determination of a suspected adverse drug reaction can utilize the Naranjo scale to demonstrate the likelihood of an adverse drug reaction. This patient scored a three on the Naranjo scale, indicating a possible adverse effect from quetiapine. Other potential etiologies of psychosis include medication-induced psychosis, major depressive disorder exacerbation, cocaine use/withdrawal, and brief psychotic disorder. Quetiapine-induced psychosis has not been described in the current literature, and therefore, this case report is solely based on clinical evaluation and is intended for educational purposes due to possible confounding factors and etiologies.
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Affiliation(s)
| | - Ankur Kayastha
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
| | | | - Anh Thu N Nguyen
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
| | - Riley G Fisher
- College of Life Sciences, Brigham Young University, Provo, USA
| | - Hanh M Pham
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
- Public Health, University of Nebraska Medical Center, Omaha, USA
| | - Saif A Meimon
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
| | - Alexander Phu
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
| | - Connor A Parry
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
| | - Joshua J Nelson
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
| | - Ethan C Hayes
- College of Osteopathic Medicine, Kansas City University, Joplin, USA
| | - Sunita Muranjan
- Psychiatry, Integrated Psychiatric Consultants, Kansas City, USA
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Muacevic A, Adler JR. Traumatic Brain Injury Induced Secondary Psychosis in a Young African American Male. Cureus 2022; 14:e30416. [PMID: 36407181 PMCID: PMC9669816 DOI: 10.7759/cureus.30416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 01/25/2023] Open
Abstract
Traumatic brain injury (TBI) is an intricate process in which the chemical balance and physical structure of the brain are altered. This medical condition's effects range from altered mental status to an irreversible comatose state, and in severe cases even death. TBI affects millions of individuals worldwide on an annual basis. In the United States, approximately 2.87 million TBI-related emergency department (ED) visits were reported in 2014, and nearly 43% of these cases will experience long-term disabilities. These disabilities have both short- and long-term consequences on health, ranging from physical, emotional, and psychosocial changes in an individual. The goal of this case report is to highlight the morbidity of patients with TBI, with a key focus on TBI-induced secondary psychosis. While many patients recover from their symptoms of TBI within weeks to months, a subdivision of patients with TBI has permanent damage that will significantly affect the quality of their daily lives. TBI-induced secondary psychosis is the new onset of psychosis that can comprise visual, auditory, and tactile hallucinations, delusions, and disorganized thoughts. In this case report, the patient is a 22-year-old African American male who suffered a TBI at the age of 16. Prior to the patient's TBI sustained in 2016, the patient did not have a hospital record of past psychiatric illness. In addition, the patient's family history did not show evidence of schizophrenia, bipolar, or depression in close or distant relatives. The patient presented to the ED for a psychiatric evaluation due to psychotic behavior. In this case report, we will discuss the pathogenesis, clinical presentation, and other secondary causes of TBI-induced secondary psychosis.
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Abstract
The use of antimalarial drugs for prophylaxis is a widespread practice while traveling to underdeveloped nations, particularly those with a high malaria prevalence. Chloroquine is still one of the most commonly recommended antimalarials, either alone or in combination with others, for prophylaxis. However, its increased use over the past few decades has been associated with many adverse effects, including headaches, dizziness, vomiting, and diarrhea, as well as neuropsychiatric symptoms such as psychosis. Here, we discuss the case of a 30-year-old Asian man who, after starting a 500-milligram (mg) prophylactic dosage of chloroquine per week, developed psychotic symptoms. This case highlights the need to use chloroquine and other antimalarials with care, especially when beginning as a prophylactic measure with the lowest suggested dosage.
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Iamjan SA, Thanoi S, Watiktinkorn P, Fachim H, Dalton CF, Nudmamud-Thanoi S, Reynolds GP. Changes of BDNF exon IV DNA methylation are associated with methamphetamine dependence. Epigenomics 2021; 13:953-965. [PMID: 34008409 DOI: 10.2217/epi-2020-0463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Aim: We investigated DNA methylation of BDNF in methamphetamine (METH) dependence in humans and an animal model. Materials & methods: BDNF methylation at exon IV was determined by pyrosequencing of blood DNA from METH-dependent and control subjects, and from rat brain following an escalating dose of METH or vehicle. Bdnf expression was determined in rat brain. Results: BDNF methylation was increased in human METH dependence, greatest in subjects with psychosis and in prefrontal cortex of METH-administered rats; rat hippocampus showed reduced Bdnf methylation and increased gene expression. Conclusion: BDNF methylation is abnormal in human METH dependence, especially METH-dependent psychosis, and in METH-administered rats. This may influence BDNF expression and contribute to the neurotoxic effects of METH exposure.
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Affiliation(s)
- Sri-Arun Iamjan
- Department of Anatomy, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand.,Centre of Excellence in Medical Biotechnology, Naresuan University, Phitsanulok 65000, Thailand.,Department of Biomedical Sciences, Faculty of Allied Health Sciences, Burapha University, Chonburi 20131, Thailand
| | - Samur Thanoi
- Department of Anatomy, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand.,Centre of Excellence in Medical Biotechnology, Naresuan University, Phitsanulok 65000, Thailand
| | | | - Helene Fachim
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield S1 1WB, UK.,Department of Endocrinology and Metabolism, Salford Royal NHS Foundation Trust, Salford M6 8HD, UK
| | - Caroline F Dalton
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Sutisa Nudmamud-Thanoi
- Department of Anatomy, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand.,Centre of Excellence in Medical Biotechnology, Naresuan University, Phitsanulok 65000, Thailand
| | - Gavin P Reynolds
- Centre of Excellence in Medical Biotechnology, Naresuan University, Phitsanulok 65000, Thailand.,Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield S1 1WB, UK
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Sobanski E, Dalm S, Sievers L, Külzer T, Liesenfeld H, Schmidt-Kittler H, Huss M. Herbal High: Substance-Induced Psychosis after Consumption of Seeds of the Hawaiian Baby Woodrose. Z Kinder Jugendpsychiatr Psychother 2021; 49:307-311. [PMID: 33661700 DOI: 10.1024/1422-4917/a000792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Seeds of the Hawaiian Baby Woodrose (HBWR, Argyreia nervosa) are known as "legal or herbal highs" and can be easily purchased online in Germany. They contain various ergot alkaloids, including lysergic acid amide (LSA), which is chemically related to lysergic acid diethylamide (LSD). Pharmacological data are limited but suggest that LSA-concentration in HBWR seeds is highly variable, and that adverse psychiatric and somatic effects are not related to LSA-dosage. Anecdotal, mostly cross-sectional clinical case reports describe spontaneous remission of intoxication-related somatic and psychiatric symptoms as well as intoxication-related death. Treatment recommendations for LSA-induced psychiatric syndromes are not available. We report here on the clinical course and treatment of a drug-induced psychosis after consumption of HBWR seeds. The adolescent had consumed HBWR seeds once before without suffering any negative effects.
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Affiliation(s)
- Esther Sobanski
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Mainz, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Rheinhessen Clinics, Mainz, Germany
| | - Saskia Dalm
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Rheinhessen Clinics, Mainz, Germany
| | - Luisa Sievers
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Rheinhessen Clinics, Mainz, Germany
| | - Tim Külzer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Rheinhessen Clinics, Mainz, Germany
| | - Heinz Liesenfeld
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Rheinhessen Clinics, Mainz, Germany
| | - Halgard Schmidt-Kittler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Rheinhessen Clinics, Mainz, Germany
| | - Michael Huss
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Mainz, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Rheinhessen Clinics, Mainz, Germany
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Abstract
Some people who experience substance-induced psychosis later develop an enduring psychotic disorder such as schizophrenia. This study examines the proportion of people with substance-induced psychoses who transition to schizophrenia, compares this to other brief and atypical psychoses, and examines moderators of this risk. A search of MEDLINE, PsychINFO, and Embase identified 50 eligible studies, providing 79 estimates of transition to schizophrenia among 40 783 people, including 25 studies providing 43 substance-specific estimates in 34 244 people. The pooled proportion of transition from substance-induced psychosis to schizophrenia was 25% (95% CI 18%-35%), compared with 36% (95% CI 30%-43%) for brief, atypical and not otherwise specified psychoses. Type of substance was the primary predictor of transition from drug-induced psychosis to schizophrenia, with highest rates associated with cannabis (6 studies, 34%, CI 25%-46%), hallucinogens (3 studies, 26%, CI 14%-43%) and amphetamines (5 studies, 22%, CI 14%-34%). Lower rates were reported for opioid (12%), alcohol (10%) and sedative (9%) induced psychoses. Transition rates were slightly lower in older cohorts but were not affected by sex, country of the study, hospital or community location, urban or rural setting, diagnostic methods, or duration of follow-up. Substance-induced psychoses associated with cannabis, hallucinogens, and amphetamines have a substantial risk of transition to schizophrenia and should be a focus for assertive psychiatric intervention.
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Affiliation(s)
- Benjamin Murrie
- St George Hospital and Sutherland Hospital, South Eastern Sydney Local Health District, Kogarah, Australia
| | - Julia Lappin
- School of Psychiatry, University of NSW, Sydney, Australia,National Drug and Alcohol Research Centre, University of NSW, Sydney, Australia
| | - Matthew Large
- School of Psychiatry, University of NSW, Sydney, Australia
| | - Grant Sara
- InforMH, System Information and Analytics Branch, NSW Ministry of Health, North Ryde, Australia,Northern Clinical School, Sydney Medical School, University of Sydney, St Leonards, Australia,To whom correspondence should be addressed; PO Box 169, North Ryde NSW 1670, Australia; tel: 61-2-88775132, fax: 61-2-98875722, e-mail:
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Lappin JM, Sara GE, Farrell M. Methamphetamine-related psychosis: an opportunity for assertive intervention and prevention. Addiction 2017; 112:927-928. [PMID: 27905179 DOI: 10.1111/add.13663] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 10/17/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Julia M Lappin
- School of Psychiatry, University of New South Wales, Sydney, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Grant E Sara
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia.,InforMH, Health System Information and Performance Reporting Branch, NSW Ministry of Health, Sydney, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Manseau MW, Rajparia A, Joseph A, Azarchi S, Goff D, Satodiya R, Lewis CF. Clinical Characteristics of Synthetic Cannabinoid Use in a Large Urban Psychiatric Emergency Setting. Subst Use Misuse 2017; 52:822-825. [PMID: 28156305 DOI: 10.1080/10826084.2016.1263663] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Increasing reports of synthetic cannabinoid (SC)-related adverse events have largely comprised case reports and analyses of calls to poison control centers. Existing studies have also mostly involved white male populations. OBJECTIVES The purpose of this study is to systematically describe clinical characteristics of SC use in a relatively large, diverse, urban sample presenting to a psychiatric emergency setting. METHODS SC users (n = 110) were identified by reviewing charts (n = 948) from the psychiatric emergency service of a large, urban public hospital in the United States for November 2014, which was randomly selected from the 12 months of that year. Sociodemographic data were collected from administrative databases and clinical data were collected from the electronic medical record. RESULTS SC users were mostly non-white (90.0%) males (95.5%), who were likely to be police-involved (34.5%) and homeless (84.5%). SC users also had significant and often pre-existing psychiatric and substance use comorbidity, including acute psychotic symptoms (70.0%), more than one comorbid psychiatric diagnosis (31.8%) and primary psychotic disorder diagnosis (40.0%), past psychiatric visits to the hospital (70.9%), comorbid substance use (62.7%), agitation requiring intervention (22.7%), and the need for extended psychiatric observation (15.5%) and inpatient admission (34.5%). Relatively limited medical complications were identified. Conclusions/Importance: In this sample, SC use affected a sociodemographically disadvantaged and mentally ill population, likely exacerbating existing psychiatric problems. This is one of the only studies to systematically examine the clinical effects of SC use in a significant clinical sample, and the first study in an urban, racial/ethnic minority, and vulnerable sample.
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Affiliation(s)
- Marc W Manseau
- a Department of Psychiatry , New York University School of Medicine , New York , New York, USA.,b Department of Psychiatry , Bellevue Hospital Center , New York , New York, USA
| | - Amit Rajparia
- a Department of Psychiatry , New York University School of Medicine , New York , New York, USA.,b Department of Psychiatry , Bellevue Hospital Center , New York , New York, USA
| | - Adriana Joseph
- c The Nathan Kline Institute, Research Foundation for Mental Hygiene , Orangeburg , New York , USA
| | - Sarah Azarchi
- a Department of Psychiatry , New York University School of Medicine , New York , New York, USA
| | - Donald Goff
- a Department of Psychiatry , New York University School of Medicine , New York , New York, USA.,c The Nathan Kline Institute, Research Foundation for Mental Hygiene , Orangeburg , New York , USA
| | - Ritvij Satodiya
- a Department of Psychiatry , New York University School of Medicine , New York , New York, USA
| | - Crystal Fuller Lewis
- a Department of Psychiatry , New York University School of Medicine , New York , New York, USA.,b Department of Psychiatry , Bellevue Hospital Center , New York , New York, USA.,c The Nathan Kline Institute, Research Foundation for Mental Hygiene , Orangeburg , New York , USA
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Abstract
Psychosis has been documented to occur during treatment for idiopathic Parkinson's disease (PD). This case report describes an elderly male who developed psychosis during the course of treatment for idiopathic PD. He was treated with clozapine but experienced significant adverse effects without clinical improvement. He was prescribed bifrontal electroconvulsive therapy (BF-ECT). Here, we report the efficacy of BF-ECT in treating psychosis and motor symptoms in PD, without producing cognitive side effects in an elderly male.
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Affiliation(s)
- K Muralidharan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
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