A Case of Haloperidol as the Culprit of Neuroleptic-Induced Deficit Syndrome (NIDS) in a Patient With Bipolar I Disorder, Most Recent Episode Manic, Severe With Psychotic Features
Speaker Credentials
MD
Format
Poster
Start Date
6-11-2020 1:15 PM
End Date
6-11-2020 1:30 PM
Abstract
Introduction: Neuroleptic-Induced Deficit Syndrome has been described as mental adverse effects of neuroleptic medication resembling negative symptoms of Schizophrenia. Here we present a patient admitted as a case of Bipolar I disorder, most recent episode manic, severe with psychotic features treated with Haloperidol to which patient experienced neuroleptic induced deficit syndrome (NIDS). Upon modification of her medications, she exhibited significant improvement of psychotic symptoms, cognitive and psychomotor function. Case Description: We present a 31 year old female admitted due to paranoid delusions. Upon interview, patient exhibited labile and irritable behavior, poor boundaries, disorganized thought process, loud and tangential speech, as well as paranoid delusions towards family members. Patient was started on Haloperidol 5mg and valproic acid 250 mg both twice a day. Full work up for first psychotic episode was done inpatient, including Brain CT. All results were normal. Haloperidol was uptitrated, but patient progressively showed blunted affect, apathy, alogia, became withdrawn, guarded, exhibited thought blocking, and psychomotor retardation. All antipsychotic medication was stopped for 24 hours. Medications were switched to Quetiapine 25 mg BID with marked improvement of psychiatric symptoms, as well as cognitive and psychomotor function. Patient remained on Quetiapine 25mg and valproic acid 500mg twice a day. Discussion: NIDS has been described as an emerging issue with limited literature requiring objective data. This case highlights that failure to recognize NIDS can lead to misdiagnosis, suboptimal treatment leading to a decline of patients’ cognitive function and overall mental health therefore prompt recognition can lead to favorable outcomes.
A Case of Haloperidol as the Culprit of Neuroleptic-Induced Deficit Syndrome (NIDS) in a Patient With Bipolar I Disorder, Most Recent Episode Manic, Severe With Psychotic Features
Introduction: Neuroleptic-Induced Deficit Syndrome has been described as mental adverse effects of neuroleptic medication resembling negative symptoms of Schizophrenia. Here we present a patient admitted as a case of Bipolar I disorder, most recent episode manic, severe with psychotic features treated with Haloperidol to which patient experienced neuroleptic induced deficit syndrome (NIDS). Upon modification of her medications, she exhibited significant improvement of psychotic symptoms, cognitive and psychomotor function. Case Description: We present a 31 year old female admitted due to paranoid delusions. Upon interview, patient exhibited labile and irritable behavior, poor boundaries, disorganized thought process, loud and tangential speech, as well as paranoid delusions towards family members. Patient was started on Haloperidol 5mg and valproic acid 250 mg both twice a day. Full work up for first psychotic episode was done inpatient, including Brain CT. All results were normal. Haloperidol was uptitrated, but patient progressively showed blunted affect, apathy, alogia, became withdrawn, guarded, exhibited thought blocking, and psychomotor retardation. All antipsychotic medication was stopped for 24 hours. Medications were switched to Quetiapine 25 mg BID with marked improvement of psychiatric symptoms, as well as cognitive and psychomotor function. Patient remained on Quetiapine 25mg and valproic acid 500mg twice a day. Discussion: NIDS has been described as an emerging issue with limited literature requiring objective data. This case highlights that failure to recognize NIDS can lead to misdiagnosis, suboptimal treatment leading to a decline of patients’ cognitive function and overall mental health therefore prompt recognition can lead to favorable outcomes.