A substantial percentage of patients will have an inadequate response to
clozapine in treatment resistance schizophrenia. Therefore, different
approaches need to be considered for managing this group of patients. We
present a case of a treatment resistant schizophrenia patient who shows poor
response toward clozapine. Later, he was started with haloperidol. Even
though antipsychotic superiority of clozapine in relation to haloperidol is
significant, this patient demonstrated otherwise.
Obsessive Compulsive Disorder (OCD) may present in the prodromal phase
of schizophrenia. However at times it is difficult to distinguish between the
pure obsession and psychotic obsessions that exist in patients. We present a
case of a patient initially diagnosed as Schizophrenia due to the disorganized
aspect of her behaviour, only to discover an extreme form of obsessions that
explained her demeanor throughout.
Manic symptoms secondary to hyponatremia is rare or might be underreported.
Awareness of this phenomenon is important for therapeutic
considerations of patients. We present a case of late onset mania in an elderly
gentleman who was previously diagnosed to have Major Depressive Disorder.
His manic symptoms improved without medication after sodium level was
corrected.
Sibutramine is a prohibited weight-reducing agent used in many weight-loss
products, which has been banned in many countries since 2010 including
Malaysia due to it toxicities and mortality effect. The widespread use of these
sibutramine-containing products has raised concerns regarding their side
effects, which include psychological symptoms. In this case report, we
highlight a case of psychosis induced by the use of this product. We present a
case of 36-year-old Burmese lady who has three admissions to psychiatry
ward with psychotic presentation after on-going consumption of weight-loss
product containing sibutramine.
Dissociative identity disorder (DID) previously known as multiple personality disorder is associated with depression and traumatic childhood which can be either physically or sexually abuse. It is hard to establish diagnosis of DID because of the complexity and controversies that surrounding it. We report a case of a young man who has DID and Major Depressive Disorder in the background of traumatic childhood experience who was recently admitted to our inpatient psychiatric unit and demonstrated transitions to other distinct personality state.
Huntington disease (HD) is a neurodegenerative disorder with psychiatric, cognitive, and motor symptoms. Psychiatric symptoms often manifest years before neurologic signs in HD patients. The present of psychiatric symptoms might increase risk of suicide in HD patient. We presented a case of HD who admitted to Psychiatry ward due to suicidal attempt and shows improvement with low dose of Olanzapine.