Nunez Tatiana, Meyerson Gabriella, Alani Mays, Elahi Shahid, Vargas Enrique
UCF/HCA Healthcare Graduate Medical Education Consortium, Psychiatry Residency Program, Orlando, FL.
HCA Florida Osceola Hospital, Kissimmee, FL.
HCA Healthc J Med. 2023 Feb 28;4(1):57-60. doi: 10.36518/2689-0216.1465. eCollection 2023.
Supersensitivity psychosis is a phenomenon that occurs with chronic usage of antipsychotics secondary to treatment resistance. At this time, there are no standardized guidelines regarding the management of supersensitivity psychosis.
We present a case of a patient with schizoaffective disorder who developed supersensitivity psychosis and acute dystonia in response to discontinuing psychotropic medications, including high-dose quetiapine and olanzapine. The patient presented with excessive anxiety, paranoia, bizarre thoughts, and generalized dystonia affecting the face, trunk, and extremities. We treated the patient with olanzapine, valproic acid, and diazepam, which alleviated the psychosis back to baseline and significantly improved the dystonia. Despite compliance, the patient returned for inpatient stabilization due to depressive symptoms and worsening of the dystonia. During the second admission, the patient required further modification of psychotropics and supplemental electroconvulsive therapy.
In this paper, we discuss the proposed treatment of supersensitivity psychosis, including the role that electroconvulsive therapy may play in alleviating supersensitivity psychosis and associated movement disorders. We hope to expand the knowledge of additional neuromotor manifestations in supersensitivity psychosis and the management of this unique presentation.
超敏性精神病是一种在因治疗抵抗而长期使用抗精神病药物后出现的现象。目前,关于超敏性精神病的管理尚无标准化指南。
我们报告一例患有分裂情感性障碍的患者,在停用包括高剂量喹硫平和奥氮平在内的精神药物后出现了超敏性精神病和急性肌张力障碍。患者表现为过度焦虑、妄想、怪异思维以及影响面部、躯干和四肢的全身性肌张力障碍。我们用奥氮平、丙戊酸和地西泮治疗该患者,使精神病症状缓解至基线水平,并显著改善了肌张力障碍。尽管患者依从治疗,但由于抑郁症状和肌张力障碍加重,仍需住院稳定病情。在第二次住院期间,患者需要进一步调整精神药物并辅以电休克治疗。
在本文中,我们讨论了超敏性精神病的建议治疗方法,包括电休克治疗在缓解超敏性精神病及相关运动障碍中可能发挥的作用。我们希望能拓展对超敏性精神病中其他神经运动表现及这种独特临床表现管理的认识。