Abstract
IntroductionThe usage of clozapine in patients with schizophrenia and epilepsy raises many challenges due to the epileptogenic effects of the drug. There is little data about using clozapine for treatment of treatment-resistant schizophrenia (TRS) accompanied by epilepsy.ObjectivesTo present a case report illustrating a patient diagnosed with epilepsy and TRS, successfully treated with clozapine.MethodsA literature review on “PubMed” database was conducted, using the keywords: clozapine, antipsychotics, epilepsy, seizures, psychoses. Information regarding the clinical case was obtained by consulting the patient’s file.ResultsWe present a woman, 33 years old with mild intellectual disability and a 10-year history of schizophrenia. At the age of 24, the patient lost consciousness and experienced tonic – clonic seizure, but epilepsy was not diagnosed. The patient was hospitalized multiple times due to positive symptoms of schizophrenia and suicidal thoughts. Various combinations of neuroleptics and electroconvulsive therapy were used for treatment without therapeutic effect. At the age of 32, a diagnosis of TRS was established, leading to treatment with a moderate clozapine dose (400mg/day). At the fifth month of treatment with clozapine un episode of generalized seizures occurred, leading to a diagnosis of idiopathic generalized epilepsy. Since then, the patient was treated with levetiracetam and the dosage of clozapine was lowered to 275mg/d. The seizures did not re-occur and clinical response to the psychiatric treatment was positive.ConclusionsThis case report highlights how clozapine can be used safely and effectively for patients with TRS and epilepsy and how the epileptogenic effects can be moderated by using antiepileptics in the overall treatment scheme.DisclosureNo significant relationships.
Highlights
Yoga may pose a promising complementary therapy in the multimodal treatment of schizophrenia spectrum disorders (SSD)
Twenty-five semi-structured interviews were conducted with in-patients with SSD after they participated in a Yoga-based group therapy (YBGT) session
Future research should examine to what extent these effects can be sustained and how the mindful approach during YBGT can be transferred to areas outside the Yoga class
Summary
Impaired response to stress and a pathological activation of the hypothalamic-pituitary-adrenal axis have been implicated in the pathophysiology of schizophrenia Objectives: To measure serum ACTH, cortisol and DEHA-S levels in drug-naïve, first-episode patients with psychosis. Methods: Results are reported as mean (standard deviation, range). Paired t-test or Wilcoxon signed rank test were performed for
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