Psychotropic Management in Cotard Syndrome: Case Reports Supporting Dual Medication Management.

Cotard syndrome is a rare presentation where patients present with nihilistic thoughts of dying or already being dead. These delusions manifest from either a medical or psychiatric etiology and can be difficult to treat. Recently Couto and Gonçalves purposed that treatment should include an atypical antipsychotic alone or in combination with either a mood stabilizer or antidepressant.

Nortriptyline-Induced Room Tilt Illusion.

Room tilt illusion (RTI) is a rare and transient perceptual disturbance in which an individual perceives their surroundings as having been rotated or tilted, usually at 90 or 180 degrees. Primarily linked with vestibular disorders and neurological lesions, this report details the only reported occurrence of the RTI phenomena in nortriptyline use for treatment-refractory depression. The patient developed RTI six days after starting the medication and the disturbance resolved after medication cessation.

Pimavanserin Use in Lewy Body Dementia: A Case Report Demonstrating the Medication's Efficacy.

Pimavanserin is an antipsychotic that is approved for use in Parkinson's disease psychosis. Working as a serotonin 2A inverse agonist, pimavanserin allows patients to improve their psychotic symptoms without worsening the motor symptoms of Parkinson's. This mechanism is mediated via serotonin receptors and may allow for pimavanserin to be considered for use in other disease processes that present with psychosis.

A Case of Neuroleptic Malignant Syndrome in the Context of Lithium Toxicity and Aripiprazole Use.

Objective: Neuroleptic malignant syndrome (NMS) is a rare life-threatening condition that providers should be cognizant of when prescribing dopamine-receptor antagonists. Atypical antipsychotic agents were initially considered to have a lower risk of inducing the development of NMS compared with conventional antipsychotic. Considerable evidence, however, has suggested that atypical antipsychotics are associated with NMS, including the partial dopamine agonist, aripiprazole.

Clozapine and COVID-19: A Case Report and Clinical Considerations.

Background: The emergence of coronavirus SARS-CoV-2, and the subsequent global epidemic of COVID-19, brought with it innumerable new clinical experiences across all medical specialties, and psychiatry is no exception. Individuals with serious mental illness, in particular schizophrenia and related disorders, may be especially susceptible to coronavirus infection given the overlapping risk factors of vulnerable sociodemographic status, increased challenges with quarantining requirements, and limited compliance with "respiratory etiquette." The case presented here describes a patient with schizophrenia who was being managed on clozapine and who developed symptomatic COVID-19 infection.

Psychotic pregnancy denial: a review of the literature and its clinical considerations.

Background: Pregnancy denial can be broken into two major types, non-psychotic and psychotic deniers, and further classified into pervasive, affective and persistent sub-types. It can lead to increased morbidity and mortality of the mother and neonate. Psychotic pregnancy denial is rare and the medical literature existing on the subject is limited to a small number of case reports and case series.

Delirium Secondary to Lamotrigine Toxicity.

Background: Lamotrigine is a phenyltriazine medication that has been approved by the United States Food and Drug Administration as monotherapy and as an adjunctive agent for the treatment of seizure disorder. It was later approved by the FDA for the treatment of bipolar disorder. Lamotrigine is generally well tolerated by patients, but some serious symptoms can occur during treatment.

Couvade syndrome: more than a toothache.

Background: Couvade Syndrome is best characterized as a somatic symptom disorder where the partner experiences somatic symptoms during their partner's pregnancy most often during the first and third trimesters. Several psychoanalytical theories have been proposed for this disorder. There are well studied mood changes that correspond to hormonal shifts that occur in response to anticipated parenthood which serve as a physiologic mechanism for this pathology.