Lorazepam provocation test in purported schizophrenia with lack of treatment response
Some patients with severe mental disorders are refractory to psychotherapeutic or psychopharmacological interventions. We present a patient who at the age of 19 developed several schizophrenia - suspect symptoms. Soon inexplicable general seizures where observed. He was treated with antipsychotics,...
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doaj-b6418042fc5c4ea98d225246159597bd2020-11-25T03:09:27ZengEmerald PublishingMental Illness2036-74572036-74652014-09-016210.4081/mi.2014.56272993Lorazepam provocation test in purported schizophrenia with lack of treatment responseJohn E. Berg0Department of Acute Psychiatry, Ålesund Hospital, Møre and Romsdal Regional Health Authority, Ålesund; Faculty of Health Sciences, Oslo and Akershus University CollegeSome patients with severe mental disorders are refractory to psychotherapeutic or psychopharmacological interventions. We present a patient who at the age of 19 developed several schizophrenia - suspect symptoms. Soon inexplicable general seizures where observed. He was treated with antipsychotics, but had two bouts of malignant neuroleptic syndrome. Electroconvulsive therapy (ECT) gave some symptom relief and he continued on maintenance ECT for years with weekly intervals. Interruption of this treatment pattern rapidly increased symptom load. After seven years a lorazepam provocation test was performed as he had a new relapse after 3 weeks without ECT. In the ensuing hours his aggressiveness and nonsense speaking rapidly diminished. Kahlbaums observation of seizures as part of a catatonia was not understood in this case. The publication of the new DSM-V diagnosis of catatonia may hopefully reduce the probability of treating a patient for schizophrenia for years without access to a more targeted medication and ECT plan.http://www.pagepress.org/journals/index.php/mi/article/view/5626electroconvulsive treatment, side effects, catatonia, schizophrenia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
John E. Berg |
spellingShingle |
John E. Berg Lorazepam provocation test in purported schizophrenia with lack of treatment response Mental Illness electroconvulsive treatment, side effects, catatonia, schizophrenia |
author_facet |
John E. Berg |
author_sort |
John E. Berg |
title |
Lorazepam provocation test in purported schizophrenia with lack of treatment response |
title_short |
Lorazepam provocation test in purported schizophrenia with lack of treatment response |
title_full |
Lorazepam provocation test in purported schizophrenia with lack of treatment response |
title_fullStr |
Lorazepam provocation test in purported schizophrenia with lack of treatment response |
title_full_unstemmed |
Lorazepam provocation test in purported schizophrenia with lack of treatment response |
title_sort |
lorazepam provocation test in purported schizophrenia with lack of treatment response |
publisher |
Emerald Publishing |
series |
Mental Illness |
issn |
2036-7457 2036-7465 |
publishDate |
2014-09-01 |
description |
Some patients with severe mental disorders are refractory to psychotherapeutic or psychopharmacological interventions. We present a patient who at the age of 19 developed several schizophrenia - suspect symptoms. Soon inexplicable general seizures where observed. He was treated with antipsychotics, but had two bouts of malignant neuroleptic syndrome. Electroconvulsive therapy (ECT) gave some symptom relief and he continued on maintenance ECT for years with weekly intervals. Interruption of this treatment pattern rapidly increased symptom load. After seven years a lorazepam provocation test was performed as he had a new relapse after 3 weeks without ECT. In the ensuing hours his aggressiveness and nonsense speaking rapidly diminished. Kahlbaums observation of seizures as part of a catatonia was not understood in this case. The publication of the new DSM-V diagnosis of catatonia may hopefully reduce the probability of treating a patient for schizophrenia for years without access to a more targeted medication and ECT plan. |
topic |
electroconvulsive treatment, side effects, catatonia, schizophrenia |
url |
http://www.pagepress.org/journals/index.php/mi/article/view/5626 |
work_keys_str_mv |
AT johneberg lorazepamprovocationtestinpurportedschizophreniawithlackoftreatmentresponse |
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