The case of acute psychotic episode treatment in patient with myasthenia gravis
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Abstract
A seventy-one old male patient with no previous Hx of mental disorders including alcohol use and with no family Hx of mental disorders was admitted to psychiatric ward due to acute aggression, agitation, excessive irritability and lack olf sleep. He suferred from myasthenia gravis for years and was treated chronically with ambenonium 20 mg daily. Because of comorbidity of uveitis with macular edema he received treatment with prednisolone 70mg daily. Because of acute psychotic symptoms the treatment with olanzapine up to 20mg/d was introduced without effect. The treatment was switched to haloperidol 10mg/d with gradual improvement of patient’s behaviour. He was discharged from the hospital with indication to continue psychiatric, ohpthalomogic, and neurological outpatient care.
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Gilhus NE, Verschuuren JJ (2015) Myasthenia gravis: subgroup classifi cation and therapeutic strategies. Lancet Neurol 14: 1023-`1036. Link: https://bit.ly/3z3LkFM
Kerty E, Elsais A, Argov Z, Evoli A, Gilhus NE (2014) EFNS/ENS Guidelines for the treatment of ocular myasthenia. Eur J Neurol 21: 687-693. Link: https://bit.ly/3v70J4R
Benatar M, Kaminski H (2012) Medical and surgical treatment for ocular myasthenia. Cochrane Database Syst Rev 12: CD005081. Link: https://bit.ly/3v2nIhE
Mehyar M, Rodrigue F, Tiffany L, Robert P (2012) Medications and Myasthenia Gravis (A Reference for Health Care Professionals), Link: https://bit.ly/3ggsL8H
Dubovsky AN, Arvikar S, Stern TA, Axelrod L (2012) The neuropsychiatric complications of glucocorticoid use: steroid psychosis revisited. Psychosomatics 53: 103-115. Link: https://bit.ly/3wZ9iAa
Verma R, Wolfe GI, Kupersmith MJ (2021) Ocular myasthenia gravis - How effective is low dose prednisone long term? J Neurol Sci 420: 117274. Link: https://bit.ly/3w6VMuj
Bolanos SH, Khan DA, Hanczyc M, Bauer MS, Dhanani N, et al. (2004) Assessment of mood states in patients receiving long-term corticosteroid therapy and in controls with patient-rated and clinician-rated scales. Ann Allergy Asthma Immunol 92: 500-505. Link: https://bit.ly/3v0NLWr
Ciriaco M, Ventrice P, Russo G, Scicchitano M, Mazzitello G, et al. (2013) Corticosteroid-related central nervous system side effects. J Pharmacol Pharmacother 4: S94- S98. Link: https://bit.ly/2T6RDIb
Wolkowitz OM, Burke H, Epel ES, Reus VI (2009) Glucocorticoids. Mood, memory, and mechanisms. Ann N Y Acad Sci 1179: 19-40. Link: https://bit.ly/3ipWLlb
Trillenberg P, Katalinic A, Junghanns K, Thern J (2021) Worsening of myasthenia due to antiepileptic, antipsychotic, antidepressant, and sedative medication: An estimation of risk based on reporting frequency. Eur J Neurol. Link: https://bit.ly/3gbRZoQ
She S, Yi W, Zhang B, Zheng Y (2017) Worsening of Myasthenia Gravis After Administration of Antipsychotics for Treatment of Schizophrenia: A Case Report and Review of Literature. J Clin Psychopharmacol 37: 620-622. Link: https://bit.ly/3gxwyyT