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Low-dose clozapine monotherapy for recurring episodes of depression, hypersomnia and behavioural disturbances: a case report

Published online by Cambridge University Press:  24 June 2014

Beata J. Havaki-Kontaxaki ,
Panagiotis P. Ferentinos ,
Vassilis P. Kontaxakis ,
Maria-Irini V. Kontaxaki ,
Xenia Geronikola ,
Ioannis Armeniakos  and
George N. Papadimitriou
Beata J. Havaki-Kontaxaki
Affiliation:
1st Department of Psychiatry, University of Athens, Eginition Hospital, Athens, Greece
Panagiotis P. Ferentinos*
Affiliation:
1st Department of Psychiatry, University of Athens, Eginition Hospital, Athens, Greece
Vassilis P. Kontaxakis
Affiliation:
1st Department of Psychiatry, University of Athens, Eginition Hospital, Athens, Greece
Maria-Irini V. Kontaxaki
Affiliation:
1st Department of Psychiatry, University of Athens, Eginition Hospital, Athens, Greece
Xenia Geronikola
Affiliation:
Department of Nuclear Medicine, Attikon University Hospital, Athens, Greece
Ioannis Armeniakos
Affiliation:
Department of Nuclear Medicine, Attikon University Hospital, Athens, Greece
George N. Papadimitriou
Affiliation:
1st Department of Psychiatry, University of Athens, Eginition Hospital, Athens, Greece
*
Panagiotis P. Ferentinos, MD, 1st Department of Psychiatry, Athens University Medical School, Eginition Hospital, 74 Vas. Sophias Ave., 11528 Athens, Greece. Tel/Fax: +30 210 7289324; E-mail: pferentinos@med.uoa.gr
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Extract

Havaki-Kontaxaki BJ, Ferentinos PP, Kontaxakis VP, Kontaxaki M-I V, Geronikola X, Armeniakos I, Papadimitriou GN. Low-dose clozapine monotherapy for recurring episodes of depression, hypersomnia and behavioural disturbances: a case report.

Case Report: We present a 27-year-old woman who manifested recurrent episodes of hypersomnia, compulsive hyperphagia, hypersexuality, impulsive behaviours, irritability and depressive mood since the age of 13 after a viral febrile infection. She had 3–4 episodes/year lasting from a few days to 2–3 weeks which were managed with various psychotropics. During her last episode, she was admitted because of persistent behavioural disturbances. Brain 99m-Tc-ethyl cysteinate dimer single-photon emission computed tomography scans showed bilateral mesiotemporal and thalamic hypoperfusion, more significant in the right hemisphere. While hospitalised, she developed neuroleptic malignant syndrome following haloperidol administration. She was discharged on clozapine 100 mg/day. Over the following 30 months, she remained symptom free on clozapine 50–100 mg/day.

Discussion: Differential diagnosis included either an atypical recurrent mood disorder with hypersomnia and behavioural disturbances or Kleine–Levin syndrome.

Conclusion: Low-dose clozapine monotherapy may worth being further investigated for the management of recurring episodes of depression, hypersomnia and behavioural disturbances.

Keywords

clozapinehypersomniaKleine–Levin syndromemood disorderssingle-photon emission computed tomography
Type
Case Reports
Information
Acta Neuropsychiatrica , Volume 23 , Issue 4 , August 2011 , pp. 191 - 193
Copyright
Copyright © Cambridge University Press 2011

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