Abstract
ABSTRACTRetinitis Pigmentosa is a rare inherited degenerative eye disease affecting the retinal pigment epithelium (RPE), in which mutation of rhodopsin leads to severe visual impairment, and legal blindness. The D4 receptors are abundant within the rods of the retina and dopamine release is the primary feedback mechanism preventing retinal degeneration by the unopposed action of melatonin. Here, we present a 50-year-old female patient with schizophrenia and retinitis pigmentosa who was admitted to an inpatient unit for an acute psychotic exacerbation with agitation and persecutory delusions. Patient initially was administered IM haloperidol since she refused oral form, but she eventually was compliant to oral Haloperidol with eventual reduction in daily dose to 5mg/d with treatment response and good tolerability including no change in visual acuity. The treatment of psychosis in patients with retinitis pigmentosa is challenging and requires consideration of the potential D4 receptor effects associated wi...
Highlights
IntroductionA 50-year-old Hispanic female with a past psychiatric history of schizophrenia and retinitis pigmentosa, and no prior admissions to our inpatient unit, brought in involuntarily by police for acute psychotic exacerbation with agitation, persecutory delusions and disorganized behaviour
A 50-year-old Hispanic female with a past psychiatric history of schizophrenia and retinitis pigmentosa, and no prior admissions to our inpatient unit, brought in involuntarily by police for acute psychotic exacerbation with agitation, persecutory delusions and disorganized behaviour.Patient has been deteriorating and non-compliant with home psychiatric medication for the past few months
We present a 50-year-old female patient with schizophrenia and retinitis pigmentosa who was admitted to an inpatient unit for an acute psychotic exacerbation with agitation and persecutory delusions
Summary
A 50-year-old Hispanic female with a past psychiatric history of schizophrenia and retinitis pigmentosa, and no prior admissions to our inpatient unit, brought in involuntarily by police for acute psychotic exacerbation with agitation, persecutory delusions and disorganized behaviour. Patient has been deteriorating and non-compliant with home psychiatric medication for the past few months She reportedly has been paranoid about people coming into her house and has called 911 numerous times claiming that someone is in her home. The patient was not sleeping or eating well, and she thinks that someone is poisoning her She stated, “The world will end if you don’t believe in God” and said that God has told her what his plans are. Patient spoke Spanish and English, and interviews were conducted with the presence of interpretation services at the hospital Her medical history and lab investigations were negative for medical issues except being legally blind due to retinitis pigmentosa and a previous cataract surgery 5 years earlier. She did not report side effects of worsening vision after adjusting her medication doses
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