Pub Date : 2025-08-24DOI: 10.1016/j.psycr.2025.100283
Bailey H. Brown , Stephan F. Taylor
It is well known that temporal lobe epilepsy (TLE), particularly of the mesial temporal lobe, is associated with peri‑ictal (including preictal, ictal, and postictal) and interictal psychosis. We present a case of a 38-year-old male with new-onset seizures secondary to a sporadically bleeding, inoperable temporal lobe cavernous malformation (CM). Followed over 17 years, he experienced recurrent seizures with auras intermittently associated with episodes of thought broadcasting. This case shows, in the absence of a primary psychotic disorder, a discrete temporal lobe lesion occurring with an isolated psychotic symptom during aura. We explore possible mechanisms for this phenomenon.
{"title":"Thought broadcasting associated with seizure aura from bleeding cerebral cavernous malformation: a case report","authors":"Bailey H. Brown , Stephan F. Taylor","doi":"10.1016/j.psycr.2025.100283","DOIUrl":"10.1016/j.psycr.2025.100283","url":null,"abstract":"<div><div>It is well known that temporal lobe epilepsy (TLE), particularly of the mesial temporal lobe, is associated with peri‑ictal (including preictal, ictal, and postictal) and interictal psychosis. We present a case of a 38-year-old male with new-onset seizures secondary to a sporadically bleeding, inoperable temporal lobe cavernous malformation (CM). Followed over 17 years, he experienced recurrent seizures with auras intermittently associated with episodes of thought broadcasting. This case shows, in the absence of a primary psychotic disorder, a discrete temporal lobe lesion occurring with an isolated psychotic symptom during aura. We explore possible mechanisms for this phenomenon.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100283"},"PeriodicalIF":0.0,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-07DOI: 10.1016/j.psycr.2025.100281
Greta Poglia, Javier Bartolomei, Marco De Pieri
This is the case of a 24-year-old woman referred to our outpatient psychiatry clinic for depression-like symptoms in the context of multiple hormonal deficits and a lesion in hypothalamus and pituitary gland. A prior diagnostic workup had identified multisystem Langerhans cell histiocytosis (LCH) with neurologic and neuroendocrine involvement. The patient was treated with hormonal replacement, corticosteroids, chemotherapy, and antidepressant medication, however, the neuropsychiatric syndrome persisted and appeared exacerbated by challenging family dynamics. Apathy was the predominant clinical feature, pointing to a distinct phenotype that is differentiable from depression. Mild improvement was noted after initiation of therapy with dexmethylphenidate, and consideration was given to oxytocin treatment, although the latter was not pursued owing to the lack of an established protocol. This case illustrates a striking neuropsychiatric phenotype of treatment-resistant apathy occurring in the setting of neuro-LCH with localized hypothalamic-pituitary lesion and multi-endocrine deficiency. The apathy syndrome was refractory to treatments targeting LCH, hormone replacement, and antidepressants, highlighting the need for a tailored approach. The potential role of psychostimulants and oxytocin replacement as therapeutic avenues in apathic patients warrants further research.
{"title":"Apathy in a young woman with Langerhans cell histiocytosis and hypopituitarism: a case report","authors":"Greta Poglia, Javier Bartolomei, Marco De Pieri","doi":"10.1016/j.psycr.2025.100281","DOIUrl":"10.1016/j.psycr.2025.100281","url":null,"abstract":"<div><div>This is the case of a 24-year-old woman referred to our outpatient psychiatry clinic for depression-like symptoms in the context of multiple hormonal deficits and a lesion in hypothalamus and pituitary gland. A prior diagnostic workup had identified multisystem Langerhans cell histiocytosis (LCH) with neurologic and neuroendocrine involvement. The patient was treated with hormonal replacement, corticosteroids, chemotherapy, and antidepressant medication, however, the neuropsychiatric syndrome persisted and appeared exacerbated by challenging family dynamics. Apathy was the predominant clinical feature, pointing to a distinct phenotype that is differentiable from depression. Mild improvement was noted after initiation of therapy with dexmethylphenidate, and consideration was given to oxytocin treatment, although the latter was not pursued owing to the lack of an established protocol. This case illustrates a striking neuropsychiatric phenotype of treatment-resistant apathy occurring in the setting of neuro-LCH with localized hypothalamic-pituitary lesion and multi-endocrine deficiency. The apathy syndrome was refractory to treatments targeting LCH, hormone replacement, and antidepressants, highlighting the need for a tailored approach. The potential role of psychostimulants and oxytocin replacement as therapeutic avenues in apathic patients warrants further research.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100281"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-07DOI: 10.1016/j.psycr.2025.100282
Riitta Kuokkanen
There is increasing evidence that metacognitive therapy (MCT; Wells, 2009) results in significant benefits in various disorders, including depression and psychosis, and may even surpass the efficacy of cognitive behavioral therapy (CBT), currently recommended in treatment guidelines. The implementation of advanced new forms of treatment, and especially research into the effectiveness of these new treatments, is often more challenging in forensic psychiatric treatment and with difficult-to-treat patients. The evidence on the effectiveness of psychological interventions in this population is still limited and research on MCT in this context is non-existent. As a first step in evaluating MCT’s feasibility and acceptability in this context, this paper describes a case example of the treatment of persistent depressive symptoms of chronic paranoid schizophrenia augmented with MCT in a forensic mental health setting. In addition to treatment as usual, i.e. medication, regular conversations with a designated nurse, and a social skills group, 18 weekly sessions of MCT following a depression treatment plan, targeting rumination/worry, attentional control, metacognitive beliefs, and dysfunctional behaviors, were delivered. The same person conducted the assessments and therapy. Clinically significant reductions in depressive symptoms and delusions were observed, assessed at pre- and post-therapy. In addition, a prominent decline in rumination, dysfunctional metacognitive beliefs and coping behaviors took place. Although the specific contribution of MCT cannot be established, it is concluded that MCT may be a useful supplement to treatment options in the treatment of difficult-to-treat patients and in a forensic setting.
{"title":"The feasibility and acceptability of metacognitive therapy in a forensic setting: a case report of chronic paranoid schizophrenia with persistent depressive symptoms","authors":"Riitta Kuokkanen","doi":"10.1016/j.psycr.2025.100282","DOIUrl":"10.1016/j.psycr.2025.100282","url":null,"abstract":"<div><div>There is increasing evidence that metacognitive therapy (MCT; Wells, 2009) results in significant benefits in various disorders, including depression and psychosis, and may even surpass the efficacy of cognitive behavioral therapy (CBT), currently recommended in treatment guidelines. The implementation of advanced new forms of treatment, and especially research into the effectiveness of these new treatments, is often more challenging in forensic psychiatric treatment and with difficult-to-treat patients. The evidence on the effectiveness of psychological interventions in this population is still limited and research on MCT in this context is non-existent. As a first step in evaluating MCT’s feasibility and acceptability in this context, this paper describes a case example of the treatment of persistent depressive symptoms of chronic paranoid schizophrenia augmented with MCT in a forensic mental health setting. In addition to treatment as usual, i.e. medication, regular conversations with a designated nurse, and a social skills group, 18 weekly sessions of MCT following a depression treatment plan, targeting rumination/worry, attentional control, metacognitive beliefs, and dysfunctional behaviors, were delivered. The same person conducted the assessments and therapy. Clinically significant reductions in depressive symptoms and delusions were observed, assessed at pre- and post-therapy. In addition, a prominent decline in rumination, dysfunctional metacognitive beliefs and coping behaviors took place. Although the specific contribution of MCT cannot be established, it is concluded that MCT may be a useful supplement to treatment options in the treatment of difficult-to-treat patients and in a forensic setting.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100282"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-25DOI: 10.1016/j.psycr.2025.100280
Cade Church , Jesse Zeng , Laura Warning , Sheevaam Patel , Tessa Manning
KarXT (xanomeline-trospium) is a novel, FDA-approved antipsychotic that targets muscarinic receptors rather than dopamine for use in patients with schizophrenia. Initial studies aimed at the approval of the drug showed a decrease in Positive and Negative Symptom Scale (PANSS) scores compared to placebo among patients who met the inclusion criteria for those studies. The present case report describes the use of KarXT in a 34-year-old male with schizoaffective disorder, depressed subtype, and opioid use disorder who would have been excluded from KarXT clinical trials due to extensive prior hospitalizations, multiple recently failed antipsychotic trials, and concurrent psychiatric polypharmacy. KarXT was discussed with the patient after failing to see improvement with multiple other antipsychotic medications, including clozapine, in the inpatient setting. He agreed to start KarXT in addition to the intramuscular paliperidone palmitate, mirtazapine, lorazepam, and trazodone he was already receiving. The patient’s baseline PANSS score was determined to be 86 just prior to his first dose of KarXT. By day 4, his PANSS score decreased to 46, representing a 47 % decrease. At 5 weeks, the patient was reevaluated via phone and determined to have a PANSS score of 52. These findings are an encouraging example of a patient with comorbid psychiatric diagnoses and concurrent medication regimens receiving benefit from KarXT. This case illustrates the potential utility of KarXT in a complex patient population typically excluded from trials, suggesting broader clinical applicability.
{"title":"Positive response to adjunctive KarXT (xanomeline/trospium) in treatment-resistant Schizophrenia: A case report","authors":"Cade Church , Jesse Zeng , Laura Warning , Sheevaam Patel , Tessa Manning","doi":"10.1016/j.psycr.2025.100280","DOIUrl":"10.1016/j.psycr.2025.100280","url":null,"abstract":"<div><div>KarXT (xanomeline-trospium) is a novel, FDA-approved antipsychotic that targets muscarinic receptors rather than dopamine for use in patients with schizophrenia. Initial studies aimed at the approval of the drug showed a decrease in Positive and Negative Symptom Scale (PANSS) scores compared to placebo among patients who met the inclusion criteria for those studies. The present case report describes the use of KarXT in a 34-year-old male with schizoaffective disorder, depressed subtype, and opioid use disorder who would have been excluded from KarXT clinical trials due to extensive prior hospitalizations, multiple recently failed antipsychotic trials, and concurrent psychiatric polypharmacy. KarXT was discussed with the patient after failing to see improvement with multiple other antipsychotic medications, including clozapine, in the inpatient setting. He agreed to start KarXT in addition to the intramuscular paliperidone palmitate, mirtazapine, lorazepam, and trazodone he was already receiving. The patient’s baseline PANSS score was determined to be 86 just prior to his first dose of KarXT. By day 4, his PANSS score decreased to 46, representing a 47 % decrease. At 5 weeks, the patient was reevaluated via phone and determined to have a PANSS score of 52. These findings are an encouraging example of a patient with comorbid psychiatric diagnoses and concurrent medication regimens receiving benefit from KarXT. This case illustrates the potential utility of KarXT in a complex patient population typically excluded from trials, suggesting broader clinical applicability.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100280"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-23DOI: 10.1016/j.psycr.2025.100279
Alonso Elías Garrido-Pinzás , Marcelo Cruzalegui , Cynthia Cabrejos Novoa
Introduction
Abrupt clozapine discontinuation can trigger a rare withdrawal syndrome characterized by psychosis, serotonergic symptoms, catatonia, and cholinergic rebound symptoms.
Case presentation
We report a 37-year-old woman with schizoaffective disorder who accidentally stopped clozapine abruptly, leading to severe psychomotor agitation, psychosis, catatonia, and dysautonomia, requiring hospitalization. Differential diagnoses, including neuroleptic malignant syndrome, were considered. Symptoms gradually improved upon reintroducing clozapine, confirming the diagnosis of clozapine withdrawal syndrome.
Discussion
Clozapine withdrawal syndrome may be underdiagnosed. The most effective treatment is to restart clozapine; gradual tapering is preferred to avoid complications when discontinuation is necessary.
Conclusion
Awareness of clozapine withdrawal is crucial for early diagnosis and treatment.
{"title":"Clozapine withdrawal syndrome; a case report","authors":"Alonso Elías Garrido-Pinzás , Marcelo Cruzalegui , Cynthia Cabrejos Novoa","doi":"10.1016/j.psycr.2025.100279","DOIUrl":"10.1016/j.psycr.2025.100279","url":null,"abstract":"<div><h3>Introduction</h3><div>Abrupt clozapine discontinuation can trigger a rare withdrawal syndrome characterized by psychosis, serotonergic symptoms, catatonia, and cholinergic rebound symptoms.</div></div><div><h3>Case presentation</h3><div>We report a 37-year-old woman with schizoaffective disorder who accidentally stopped clozapine abruptly, leading to severe psychomotor agitation, psychosis, catatonia, and dysautonomia, requiring hospitalization. Differential diagnoses, including neuroleptic malignant syndrome, were considered. Symptoms gradually improved upon reintroducing clozapine, confirming the diagnosis of clozapine withdrawal syndrome.</div></div><div><h3>Discussion</h3><div>Clozapine withdrawal syndrome may be underdiagnosed. The most effective treatment is to restart clozapine; gradual tapering is preferred to avoid complications when discontinuation is necessary.</div></div><div><h3>Conclusion</h3><div>Awareness of clozapine withdrawal is crucial for early diagnosis and treatment.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100279"},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-13DOI: 10.1016/j.psycr.2025.100270
Rachel Bigley , Ricardo Roda , Sarah Collica
Late Onset Tay-Sachs Disease (LOTS) is an autosomal recessive genetic neurodegenerative condition that is associated with neurologic symptoms such as incoordination, imbalance, tremor, dysarthria, and cognitive decline. It is known that those with this genetic condition have an increased risk of severe mental illness including Bipolar Spectrum Affective Disorder (BPAD). However, there is limited evidence for which medications are effective in treating psychiatric illness in these people without causing worsening neurologic symptoms. We present the case of a young woman who presented with rapid mood cycling following a recent diagnosis of LOTS. We show that this patient was safely and effectively treated with olanzapine (Zyprexa) and Lithium with return to her mental health baseline, no worsening of neurological symptoms, and continued stability at 5 months follow-up.
{"title":"A case report on treatment of bipolar disorder in Late Onset Tay-Sachs disease","authors":"Rachel Bigley , Ricardo Roda , Sarah Collica","doi":"10.1016/j.psycr.2025.100270","DOIUrl":"10.1016/j.psycr.2025.100270","url":null,"abstract":"<div><div>Late Onset Tay-Sachs Disease (LOTS) is an autosomal recessive genetic neurodegenerative condition that is associated with neurologic symptoms such as incoordination, imbalance, tremor, dysarthria, and cognitive decline. It is known that those with this genetic condition have an increased risk of severe mental illness including Bipolar Spectrum Affective Disorder (BPAD). However, there is limited evidence for which medications are effective in treating psychiatric illness in these people without causing worsening neurologic symptoms. We present the case of a young woman who presented with rapid mood cycling following a recent diagnosis of LOTS. We show that this patient was safely and effectively treated with olanzapine (Zyprexa) and Lithium with return to her mental health baseline, no worsening of neurological symptoms, and continued stability at 5 months follow-up.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100270"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.psycr.2025.100262
Fatima Al Quraish, Naista Zhand
Introduction
Aberrant feeding behaviours in schizophrenia, which could result in cachexia and starvation status, have been described in the literature. Testosterone is used as an adjunct treatment in patients with cancer and HIV-induced cachexia to increase lean body mass, and could be considered as a potential option for management of cachexia due to other causes such as schizophrenia. In this case report, we describe use of adjunct testosterone in a patient with schizophrenia and significant weight loss.
Method
We present a case report of a patient with chronic schizophrenia who was admitted to our Schizophrenia inpatient unit with relapse of psychosis, catatonia and significant weight loss/malnutrition. His weight on admission was 38.2 kg with a body mass index (BMI) of 14. He was treated with antipsychotic medications and ECT, to which he responded favourably. However, after 6 months in hospital and despite improvement of his mental status, his oral intake and weight were still suboptimal. He was started on intramuscular testosterone to enhance muscle mass, address low weight and improve energy.
Results
An improvement in energy, appetite and weight was observed. Following 13 weeks of regular treatment with testosterone, his weight increased from 45 kg to 52 kg, correlating to a 15.5% increase in total body weight. There were no adverse effects.
Conclusions
Supplementary testosterone can be considered as an adjunct option for treatment of persistent cachexia in patients with schizophrenia who continue to struggle with low body weight and low energy, despite optimized psychiatric treatment.
{"title":"Testosterone use as a treatment of cachexia in patients with schizophrenia: A case report","authors":"Fatima Al Quraish, Naista Zhand","doi":"10.1016/j.psycr.2025.100262","DOIUrl":"10.1016/j.psycr.2025.100262","url":null,"abstract":"<div><h3>Introduction</h3><div>Aberrant feeding behaviours in schizophrenia, which could result in cachexia and starvation status, have been described in the literature. Testosterone is used as an adjunct treatment in patients with cancer and HIV-induced cachexia to increase lean body mass, and could be considered as a potential option for management of cachexia due to other causes such as schizophrenia. In this case report, we describe use of adjunct testosterone in a patient with schizophrenia and significant weight loss.</div></div><div><h3>Method</h3><div>We present a case report of a patient with chronic schizophrenia who was admitted to our Schizophrenia inpatient unit with relapse of psychosis, catatonia and significant weight loss/malnutrition. His weight on admission was 38.2 kg with a body mass index (BMI) of 14. He was treated with antipsychotic medications and ECT, to which he responded favourably. However, after 6 months in hospital and despite improvement of his mental status, his oral intake and weight were still suboptimal. He was started on intramuscular testosterone to enhance muscle mass, address low weight and improve energy.</div></div><div><h3>Results</h3><div>An improvement in energy, appetite and weight was observed. Following 13 weeks of regular treatment with testosterone, his weight increased from 45 kg to 52 kg, correlating to a 15.5% increase in total body weight. There were no adverse effects.</div></div><div><h3>Conclusions</h3><div>Supplementary testosterone can be considered as an adjunct option for treatment of persistent cachexia in patients with schizophrenia who continue to struggle with low body weight and low energy, despite optimized psychiatric treatment.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 1","pages":"Article 100262"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-24DOI: 10.1016/j.psycr.2025.100261
Barbora Provaznikova, Sebastian Olbrich, Erich Seifritz, MaximilianDominik Haas, Golo Kronenberg
Nitrous oxide (N2O, laughing gas) is a colorless gas commonly used as an anesthetic and analgesic, delivered in an oxygen mixture to prevent hypoxia, with concentrations up to 70 % considered as safe (Knuf and Maani, 2024). Recently, N2O has gained significant attention in psychiatry as a promising new treatment for patients suffering from treatment-resistant depression (TRD). Rapid antidepressant effects similar to ketamine have been reported, although more research is still needed in particular in regard to the long-term efficacy of N2O (e.g., Kronenberg et al., 2024). This report presents the case of a 65-year-old woman with generalized anxiety disorder and chronic major depression, who underwent two 30 min N2O treatment sessions. Following treatment, she achieved remission and reported sustained well-being without signs of depression or anxiety at a three-month follow-up.
{"title":"Sustained remission of treatment-resistant depression following two inhalations of nitrous oxide: A case report","authors":"Barbora Provaznikova, Sebastian Olbrich, Erich Seifritz, MaximilianDominik Haas, Golo Kronenberg","doi":"10.1016/j.psycr.2025.100261","DOIUrl":"10.1016/j.psycr.2025.100261","url":null,"abstract":"<div><div>Nitrous oxide (N2O, laughing gas) is a colorless gas commonly used as an anesthetic and analgesic, delivered in an oxygen mixture to prevent hypoxia, with concentrations up to 70 % considered as safe (Knuf and Maani, 2024). Recently, N2O has gained significant attention in psychiatry as a promising new treatment for patients suffering from treatment-resistant depression (TRD). Rapid antidepressant effects similar to ketamine have been reported, although more research is still needed in particular in regard to the long-term efficacy of N2O (e.g., Kronenberg et al., 2024). This report presents the case of a 65-year-old woman with generalized anxiety disorder and chronic major depression, who underwent two 30 min N2O treatment sessions. Following treatment, she achieved remission and reported sustained well-being without signs of depression or anxiety at a three-month follow-up.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 1","pages":"Article 100261"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-26DOI: 10.1016/j.psycr.2025.100260
Sophie Scharner , Terrance M Dolan , Eric P Hazen
Background
In the below case report, we describe the development of psychotic and catatonic symptoms in an individual with Arginine-Glycine-Amindinotransferase (AGAT) deficiency, requiring creatine supplementation.
Basic Procedures and Main Findings
We have conducted a literature review and to our knowledge this is the first documented instance of psychiatric symptoms of this kind developing in an individual with AGAT deficiency.
Principal Conclusions
This case provides clinical support for the role of brain creatine metabolism in the development of psychotic and catatonic symptoms.
{"title":"Creatine metabolism in psychosis and catatonia: A case report and review of the literature","authors":"Sophie Scharner , Terrance M Dolan , Eric P Hazen","doi":"10.1016/j.psycr.2025.100260","DOIUrl":"10.1016/j.psycr.2025.100260","url":null,"abstract":"<div><h3>Background</h3><div>In the below case report, we describe the development of psychotic and catatonic symptoms in an individual with Arginine-Glycine-Amindinotransferase (AGAT) deficiency, requiring creatine supplementation.</div></div><div><h3>Basic Procedures and Main Findings</h3><div>We have conducted a literature review and to our knowledge this is the first documented instance of psychiatric symptoms of this kind developing in an individual with AGAT deficiency.</div></div><div><h3>Principal Conclusions</h3><div>This case provides clinical support for the role of brain creatine metabolism in the development of psychotic and catatonic symptoms.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 1","pages":"Article 100260"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-24DOI: 10.1016/j.psycr.2025.100259
Dan Petrovitch , Jacob Spinks , Hannah B. Yoo , Lindsay Kerr , Joshua Willms , Mary Katherine Jurek , Rachel Wanzor-Box , Andrew K. Littlefield , Ben McCauley
Ketamine has demonstrated early promise for treating substance use disorder (SUD). Despite the emerging evidence for ketamine-based approaches for SUD, little has been published on the integration of ketamine-assisted psychotherapy (KAP) with existing pharmacologic, psychosocial, and peer-support approaches to treatment and recovery, including 12-step programs. Here, we present the case of a 28-year-old female treated for alcohol and opioid use disorder. We executed an inter-clinic, collaborative treatment plan that involved a psychedelic, ketamine-based regimen in combination with extant psychosocial and 12-step-based treatments for SUD. Qualitative analysis of the patient's lived experience suggested that ketamine played an important role in her self-reported experience of recovery, as she attributed psychological and spiritual changes to ketamine treatments. Specifically, this report highlights the extent to which the patient's ketamine-induced experiences overlapped with the 12 steps—specifically with respect to recognizing the seriousness of her SUD, committing to change, developing spirituality, and repairing interpersonal relationships, among other points of interface that could be useful for clinicians treating 12-step-involved SUD patients with ketamine.
Clinical impact statement
This article analyzed the correspondence between a patient's lived experience of a ketamine-based treatment regimen for addiction and the 12 steps. It suggests notable points of overlap between her ketamine experiences and the 12 steps, which could be useful to clinicians treating 12-step involved patients with ketamine.
{"title":"Qualitative analysis of a patient's experience of ketamine-assisted psychotherapy for substance use disorder: Empirical synergies with twelve-step programs","authors":"Dan Petrovitch , Jacob Spinks , Hannah B. Yoo , Lindsay Kerr , Joshua Willms , Mary Katherine Jurek , Rachel Wanzor-Box , Andrew K. Littlefield , Ben McCauley","doi":"10.1016/j.psycr.2025.100259","DOIUrl":"10.1016/j.psycr.2025.100259","url":null,"abstract":"<div><div>Ketamine has demonstrated early promise for treating substance use disorder (SUD). Despite the emerging evidence for ketamine-based approaches for SUD, little has been published on the integration of ketamine-assisted psychotherapy (KAP) with existing pharmacologic, psychosocial, and peer-support approaches to treatment and recovery, including 12-step programs. Here, we present the case of a 28-year-old female treated for alcohol and opioid use disorder. We executed an inter-clinic, collaborative treatment plan that involved a psychedelic, ketamine-based regimen in combination with extant psychosocial and 12-step-based treatments for SUD. Qualitative analysis of the patient's lived experience suggested that ketamine played an important role in her self-reported experience of recovery, as she attributed psychological and spiritual changes to ketamine treatments. Specifically, this report highlights the extent to which the patient's ketamine-induced experiences overlapped with the 12 steps—specifically with respect to recognizing the seriousness of her SUD, committing to change, developing spirituality, and repairing interpersonal relationships, among other points of interface that could be useful for clinicians treating 12-step-involved SUD patients with ketamine.</div></div><div><h3>Clinical impact statement</h3><div>This article analyzed the correspondence between a patient's lived experience of a ketamine-based treatment regimen for addiction and the 12 steps. It suggests notable points of overlap between her ketamine experiences and the 12 steps, which could be useful to clinicians treating 12-step involved patients with ketamine.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 1","pages":"Article 100259"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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