Title:Positive Psychotic Symptoms after Escitalopram Treatment in a Female Adolescent with Peroxisome Spectrum Disorder Due to PEX-6 Gene Mutation
Volume: 12
Author(s): Buket Kılıç*Dilek Ünal
Affiliation:
- Child and Adolescent Psychiatry Department, Hacettepe University, Ankara, Turkey
Keywords:
Peroxisome biogenesis disorders, zellweger spectrum disorders, psychosis, SSRI, escitalopram, bipolar disorder.
Abstract:
Introduction: In this case report, we present positive psychotic symptoms that developed
after low-dose (5 mg/day) escitalopram treatment in a 16-year-old female adolescent with a peroxisome
biogenesis disorder.
Case presentation: Two weeks after starting escitalopram treatment for depression, the patient experienced
vomiting attacks several times a day. About 2-3 days after the attacks began, the family
stopped administering escitalopram. Five days after the onset of vomiting and 2-3 days after stopping
escitalopram, the patient developed visual and auditory hallucinations and persecutory delusions.
During the patient's follow-up period, the diversity of her hallucinations and delusions increased.
When olanzapine treatment was gradually increased to 20 mg/day, the patient's psychotic
symptoms disappeared.
Conclusion: We discuss serotonin syndrome, drug-induced bipolar disorder, and psychotic disorder
in the differential diagnosis. We believe that this case report is valuable as it is the first in the literature
regarding the development of positive psychotic symptoms after SSRI use in a patient with a
peroxisome biogenesis disorder.