Antipsychotics
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Sedation and lack of efficacy: case report A 17-year-old boy developed sedation during treatment with haloperidol for acute and transient psychotic disorder. He additionally experienced lack of efficacy during treatment with haloperidol, olanzapine, sodium valproate and quetiapine. The boy presented with a two-week history of psychiatric symptoms. Following examinations, he was diagnosed with acute and transient psychotic disorder. He was initiated on treatment with oral olanzapine titrated to 15 mg/day. However, he showed no response. He was admitted to another hospital. After further examinations, he was initiated on treatment with oral sodium valproate 500 mg/day, along with oral quetiapine 100 mg/day. His CSF sample was sent for autoantibody tests. During his two days of hospitalisation, he did not show response to the treatment. Hence, his family discharged him and consulted another psychiatrist. At the time, he was started on treatment with oral haloperidol 4.5 mg/day. However, his symptoms persisted. Hence, one week later, he returned to the previous hospital. His autoantibody tests had returned positive. He was re-admitted and initiated on treatment with methylprednisolone. His symptoms gradually improved over one week. He was continued on haloperidol. However, he developed excess sedation related to haloperidol [outcome not stated]. The boy’s haloperidol was reduced to 1.5 mg/day with no exacerbation of the psychotic disorder. Subsequently, based on the findings, he was diagnosed with autoimmune psychosis. Moideen S, et al. Psychosis in a patient with anti-NMDA-receptor antibodies experiencing significant stress related to COVID-19. Brain, Behavior, and Immunity - Health 7: 803508374 Aug 2020. Available from: URL: http://doi.org/10.1016/j.bbih.2020.100125
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Reactions 17 Oct 2020 No. 1826
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