Open AccessRefractory Psychosis After Carbon Monoxide Poisoning: a Case Report
Author(s) -
C K W Wong,
M. M. Kwan,
Wai Keung Lam
Publication year - 2022
Publication title -
east asian archives of psychiatry : official journal of the hong kong college of psychiatrists = dong ya jing shen ke xue zhi : xianggang jing shen ke yi xue yuan qi kan
Language(s) - English
Resource type - Journals
eISSN - 2224-7041
DOI - 10.12809/eaap2054
Subject(s) - quetiapine , amisulpride , olanzapine , carbon monoxide poisoning , psychosis , refractory (planetary science) , clozapine , medicine , psychiatry , anesthesia , psychology , poison control , schizophrenia (object oriented programming) , emergency medicine , physics , astrobiology
We report a case of refractory psychosis after carbon monoxide poisoning in a 65-year-old woman who attempted suicide by charcoal burning in 2018. On discharge from hospital, she was bedbound, tube-fed, and had limited verbal output. In early 2019, she was able to resume oral feeding and her physical condition improved. However, she started to have paranoid ideas and auditory hallucinations. She was diagnosed as having organic brain syndrome and was prescribed with quetiapine 300 mg every night. Because of the poor clinical response, quetiapine was switched to olanzapine 20 mg every night and augmented with amisulpride and valproate sodium. However, she remained distressed, psychotic, and suicidal. She was then prescribed with clozapine 300 mg every night. Her symptoms improved despite residual auditory hallucinations remained, but she was less distressed about them.