Hemendra Singh

Abstract

Introduction: Bowel incontinence due to antipsychotic drugs is rarely seen as an adverse effect. The mechanism of it is poorly understood, though alpha antagonism is believed to play an important role, along with secondary antihistaminergic action. It is usually a self-limiting side effect though in rare cases, needs to be managed. Here we report a case of bowel incontinence associated with the use of Risperidone. Case Description: A 35-year-old Mr. A was treated with Risperidone 2mg for control of psychotic symptoms. The patient reported bowel incontinence on the fourth day of inpatient care. Other probable causes for the same were ruled out. Resolution of incontinence occurred after discontinuation of Risperidone. Discussion: In our case, the use of risperidone is a possible reason for bowel incontinence. However, not many case reports have been previously documented wherein a patient developed bowel incontinence with an antipsychotic drug. Conclusion: Risperidone associated bowel incontinence is an uncommon manifestation. Hence, clinicians should be aware of such unusual adverse event associated with Risperidone use. Keywords: Bowel incontinence, Risperidone, Antipsychotics.

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Abstract

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune condition affecting multiple organ systems including central nervous system. Its aetiology lies in abnormal antibody formation and complement activation. Neuropsychiatric manifestations are known to occur in patients with SLE, and vary from psychosis, depression, anxiety to cognitive impairment. Here we report a case of depression with psychotic symptoms and suicidal ideations associated with SLE. Case Summary: We present the case of a 30-year-old female who presented with irritability, crying spells, feeling of guilt, referential and persecutory ideations along with suicidal ideations. She was diagnosed with severe depression with psychotic symptoms associated with SLE. She improved over a period of 6 weeks with Quetiapine 300mg along with symptomatic management of underlying medical condition. Conclusions: Depression with psychotic symptoms is not an uncommon presentation of SLE. It needs comprehensive management and multidisciplinary approach. Hence physician has to be sensitized regarding neuropsychiatric manifestations of SLE for improving the morbidity and mortality associated with underlying depression. Keywords: SLE-Depression-Psychosis.

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