Serum Level Measurements Optimize Aripriprazole Treatment in Adolescent Patients

21 minors suffering from first-episode psychosis or related disorders were treated with the second-generation antipsychotic aripriprazole with serum levels being monitored over time. A significant variation of serum levels was observed in about half of the patients. Patients from Africa showed high levels of aripriprazole. In seven patients, i. e. ca. 35 % of the sample, aripriprazole treatment had to be stopped for various reasons. Therefore, serum levels of this antipsychotic (which in Germany is still considered off-label treatment before the age of 18) should be regularly monitored particularly in patients from Africa.

Periodic menstruation-linked psychosis of adolescence

Clinical reports of a psychosis with distinct presentation affecting adolescent girls have appeared sporadically over more than a century, but its specificity has not been fully recognized. The literature is briefly reviewed and our experience with 11 such patients is presented. Periodic Menstruation-Linked Psychosis of Adolescence (PMLPA) appears to have a clinical picture which differs from that of any other form of psychosis, and to respond to different therapeutic regimes being at the same time totally unresponsive to traditional antipsychotic drugs. This makes the syndrome distinct, specific and highly treatable and therefore its recognition is of considerable clinical importance.