Psychiatry research case reports最新文献

{"title":"Olanzapine-induced ankle edema: A case report on a rare adverse effect","authors":"Sabina Dahal ,&nbsp;Rishi Ram Banjade ,&nbsp;Pramod Kumar Kafle","doi":"10.1016/j.psycr.2025.100291","DOIUrl":"10.1016/j.psycr.2025.100291","url":null,"abstract":"<div><div>Olanzapine, a second-generation antipsychotic, is widely used for the treatment of schizophrenia and mood disorders but is associated with various side effects, including rare cases of peripheral edema. We report a case of a 48-year-old female with bipolar II disorder who developed bilateral pitting ankle edema 10 days after initiating olanzapine therapy. Clinical examination and investigations ruled out cardiac, renal, hepatic, and endocrine causes. The edema resolved completely within two weeks of discontinuing olanzapine and switching to amisulpride. Although peripheral edema is an uncommon adverse effect, it may mimic serious medical conditions, leading to unnecessary investigations. Several mechanisms have been proposed, including α1-adrenergic and 5-HT2 receptor blockade, contributing to vasodilation and fluid retention. This case highlights the need for clinicians to be aware of this potential reaction, allowing for timely identification and appropriate management. Reporting such cases contributes to post-marketing surveillance and supports safer, more informed use of antipsychotic medications like olanzapine.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100291"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157111","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}

{"title":"Exploring Neuropsychiatric Sequelae Arising from Complications of Serotonin Syndrome: A Case Report","authors":"Arul Sangani ,&nbsp;Pegah Yakhchalian ,&nbsp;Kimia Mondegari ,&nbsp;Olivia Erickson ,&nbsp;Fahad Molla","doi":"10.1016/j.psycr.2025.100290","DOIUrl":"10.1016/j.psycr.2025.100290","url":null,"abstract":"","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100290"},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219172","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}

{"title":"Rapid-onset black hairy tongue following clomipramine initiation and rechallenge: A case report","authors":"Daniele Cavaleri ,&nbsp;Filippo Fabio Barbieri ,&nbsp;Alessandra Bartoccetti ,&nbsp;Massimiliano Manzato ,&nbsp;Marco Otto Maria Toscano ,&nbsp;Giuseppe Carrà ,&nbsp;Francesco Bartoli","doi":"10.1016/j.psycr.2025.100289","DOIUrl":"10.1016/j.psycr.2025.100289","url":null,"abstract":"<div><div>Black hairy tongue (BHT), a benign condition characterized by hypertrophy of the filiform papillae and discoloration of the dorsal tongue, is commonly associated with antibiotic use, poor oral hygiene, lifestyle factors, and general health issues. By contrast, psychotropic drug-induced BHT is rare and typically emerges weeks to months after treatment initiation. We report the case of a 42-year-old male patient with recurrent major depressive disorder and prior use of different psychotropic medications who developed BHT within days of initiating clomipramine on two separate occasions. In the first trial, BHT resolved shortly after clomipramine discontinuation. On the second occasion, considering the effectiveness of the treatment, the absence of concerning symptoms, and the exclusion of other causes through multidisciplinary evaluation, the patient remained on clomipramine. Despite oral hygiene measures, BHT persisted. Close temporal association, reproducibility upon re-challenge, resolution upon discontinuation during the first trial, and absence of alternative explanations supported a definite causal link, as indicated by the Expanded Naranjo Adverse Drug Reaction Probability Scale. Chronic smoking and prolonged chlorhexidine mouthwash use may have contributed, though these were unlikely the individual causes. To our knowledge, this is the first report of clomipramine-induced BHT with such rapid onset and recurrence. This case highlights the importance of recognizing BHT as a potential early-onset side effect of tricyclic antidepressants, particularly clomipramine. Prompt recognition, interdisciplinary assessment, and consideration of the risk-benefit balance are essential. Although an idiosyncratic reaction – independent of clomipramine-induced xerostomia – can be hypothesized, further research is needed to clarify the mechanisms underlying antidepressant-induced BHT.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100289"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048757","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}

{"title":"Implementation of accelerated transcranial magnetic stimulation treatment for an individual with treatment-resistant depression: A case report","authors":"Hammad Khan ,&nbsp;Lelanie Ayala ,&nbsp;Carol Parise","doi":"10.1016/j.psycr.2025.100288","DOIUrl":"10.1016/j.psycr.2025.100288","url":null,"abstract":"<div><div>Major depressive disorder (MDD) is one of the most common mental disorders in the United States. Transcranial magnetic stimulation (TMS) is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of major depression. However, the frequency and duration of the treatment schedule make compliance difficult for many patients. Accelerated theta-burst transcranial magnetic stimulation (TBS-rTMS), which involves multiple sessions of TMS in a single day, has shown promise for improved clinical outcomes despite a shorter treatment duration. We present a case of a 24-year-old woman with MDD with treatment-resistant depression (TRD) who was treated with accelerated TBS-rTMS at an inpatient psychiatric facility. The patient underwent 46 treatments of TBS-TMS per day over 5 days at 110 % of motor threshold in addition to group and 1:1 therapy and medications. The patient showed improvement on the Montgomery-Åsberg Depression Rating Scale (MADRS), Patient Health Questionnaire-9 (PHQ-9), Becks Depression Inventory (BDI), and General Anxiety Disorder-7 (GAD-7) over the 5-day course of treatment. One year later, PHQ-9, BDI, and GAD-7 scores were sustained. This case suggests that TBS-rTMS be considered for cases of MDD with TRD that do not respond to other forms of therapy.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100288"},"PeriodicalIF":0.0,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048758","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}

{"title":"Psychiatric sequelae of osmotic demyelination syndrome: a literature review and novel case of mania","authors":"Hager Koraym,&nbsp;Patrick Drummond,&nbsp;Kasra Manoocheri,&nbsp;Liliya Gershengoren,&nbsp;Robert Mazgaj,&nbsp;Brian Hanrahan","doi":"10.1016/j.psycr.2025.100287","DOIUrl":"10.1016/j.psycr.2025.100287","url":null,"abstract":"","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100287"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145057085","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}

{"title":"Cariprazine for hyperactive delirium in a medically complex ICU Patient: A case report","authors":"Ibrahim Abdulrahman Alsuwailem ,&nbsp;Abdullah Alsubhi ,&nbsp;Lama Faiz Aljuaid","doi":"10.1016/j.psycr.2025.100286","DOIUrl":"10.1016/j.psycr.2025.100286","url":null,"abstract":"<div><h3>Background</h3><div>Hyperactive delirium is a dangerous and under-studied complication in critically ill patients. Management is often complicated by QTc (corrected QT interval) prolongation associated with standard antipsychotics. Cariprazine, a dopamine D₂/D₃ partial agonist with minimal cardiac risk, may offer an alternative, though its role in delirium remains unexplored. Emerging real-world evidence supports cariprazine’s use in treatment-resistant psychiatric conditions, providing indirect support for its consideration in medically complex patients (Martiadis et al., 2024)</div></div><div><h3>Case Presentation</h3><div>A 33-year-old male with end-stage renal disease, sepsis, and prolonged QTc developed severe hyperactive delirium during an ICU admission. Despite trials of olanzapine (Zyprexa), lorazepam (2 mg IV q6h), and haloperidol (5 mg IV q6h), his agitation persisted. He required intubation for safety and sedation. Supportive care included dialysis, broad-spectrum antibiotics, oxygen supplementation (nasal cannula, high-flow, then intubation), IV fluids, and enteral feeding. Psychiatry was re-consulted on June 3 and confirmed hyperactive delirium. On June 4, cariprazine 1.5 mg was administered via NG tube (capsule powder dissolved in 30 mL water). Within 48–72 h, his behavior improved, coinciding with correction of metabolic derangements, resolution of sepsis, and stabilization of renal function. He was successfully extubated and discharged psychiatrically and medically stable.</div></div><div><h3>Conclusion</h3><div>This case suggests that cariprazine may be a potential alternative in ICU patients with hyperactive delirium and QTc concerns. However, clinical improvement was multifactorial, reflecting both psychiatric pharmacotherapy and comprehensive ICU management. This single case highlights the importance of multidisciplinary care and should be considered hypothesis-generating.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100286"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060515","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}

{"title":"Beyond stabilization: Augmenting LAI aripiprazole with xanomeline–trospium in schizophrenia – A case series","authors":"Parinda Parikh ,&nbsp;Aatish Dutta Bhatta ,&nbsp;Alisha Arul Alphonse ,&nbsp;Jeremy Kays ,&nbsp;Shaurya Kumar Singh ,&nbsp;Himani J Suthar ,&nbsp;Arnesh Shukla ,&nbsp;Mahiya Buddhavarapu ,&nbsp;Arushi Kaushik-Chandra ,&nbsp;Zoe Gellert ,&nbsp;Mina Oza","doi":"10.1016/j.psycr.2025.100285","DOIUrl":"10.1016/j.psycr.2025.100285","url":null,"abstract":"<div><h3>Background</h3><div>Schizophrenia is a chronic psychiatric disorder characterized by positive symptoms (e.g., hallucinations, delusions), negative symptoms (e.g., avolition, blunted affect), and general psychopathology (e.g., anxiety, cognitive deficits). Long-acting injectable (LAI) antipsychotics such as aripiprazole are effective for controlling positive symptoms, yet negative symptoms and general psychopathology often persist, impairing functional recovery and quality of life. Interest has grown in treatments that target non-dopaminergic pathways. Xanomeline–trospium chloride (KarXT, Cobenfy™)—a central M1/M4 muscarinic agonist combined with a peripheral anticholinergic—represents a novel adjunctive approach. This case series describes the use of KarXT in patients maintained on LAI aripiprazole who had persistent negative and general psychopathology symptoms, with the aim of exploring potential clinical benefit through cholinergic modulation.</div></div><div><h3>Cases</h3><div>Four male patients (ages 20–29) with schizophrenia, all stabilized on LAI aripiprazole, presented with residual negative symptoms such as avolition, blunted affect, and emotional withdrawal, along with general psychopathology symptoms, despite adequate control of positive symptoms. Adjunctive KarXT (xanomeline 50 mg / trospium 20 mg BID, titrated to xanomeline 100 mg / trospium 20 mg BID) was administered for 10 weeks. Positive and Negative Syndrome Scale (PANSS) assessments were conducted by trained raters. Across cases, reductions were observed in total PANSS scores (mean reduction 32.1 %), with the largest changes in negative and general psychopathology subscales. Patients also reported subjective improvements in motivation, social engagement, and emotional expressiveness.</div></div><div><h3>Discussion</h3><div>Findings from prior randomized controlled trials have shown KarXT to reduce PANSS scores, though its effects on negative symptoms remain under investigation. In this small, uncontrolled case series, observed improvements may reflect potential benefit, but causality cannot be inferred. The absence of a control group, potential placebo effects, and concurrent treatments are important limitations. Compared with options such as clozapine, which may be limited by side effects and monitoring requirements, KarXT may represent a tolerable adjunctive strategy warranting further controlled study.</div></div><div><h3>Conclusion</h3><div>Adjunctive KarXT in patients with schizophrenia stabilized on LAI aripiprazole was associated with observed improvements in negative and general psychopathology symptoms in this small case series. These preliminary findings support further investigation in larger, randomized controlled trials to determine efficacy, safety, and optimal use in real-world clinical settings.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100285"},"PeriodicalIF":0.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145009545","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}

{"title":"Complete resolution of urge urinary incontinence following treatment of ADHD with lisdexamfetamine: a case report","authors":"Adem T. Can ,&nbsp;Jim Lagopoulos","doi":"10.1016/j.psycr.2025.100284","DOIUrl":"10.1016/j.psycr.2025.100284","url":null,"abstract":"<div><div>This case report describes the complete and sustained resolution of urge urinary incontinence in a 50-year-old woman diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD) Level 1, and complex post-traumatic stress disorder (cPTSD), following initiation of lisdexamfetamine. The patient experienced urge urinary incontinence for years, which resolved entirely within weeks of commencing lisdexamfetamine at a therapeutic dose for ADHD. This clinical observation raises the possibility of a previously unrecognised neuroregulatory effect of stimulant pharmacotherapy on central bladder control mechanisms. This case suggests the need for further investigation into the interplay between neurodevelopmental disorders, psychiatric comorbidity, and lower urinary tract function.</div><div>No published data to date have identified lisdexamfetamine as a modulator of continence. Limited evidence exists for atomoxetine in paediatric nocturnal enuresis, but stimulant effects on adult urge incontinence remain undocumented.</div></div>","PeriodicalId":74594,"journal":{"name":"Psychiatry research case reports","volume":"4 2","pages":"Article 100284"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908968","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}

{"title":"Thought broadcasting associated with seizure aura from bleeding cerebral cavernous malformation: a case report","authors":"Bailey H. Brown ,&nbsp;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}

{"title":"Apathy in a young woman with Langerhans cell histiocytosis and hypopituitarism: a case report","authors":"Greta Poglia,&nbsp;Javier Bartolomei,&nbsp;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}