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A Case of Resolution of an Acute Psychotic Episode After High Fever

Published online by Cambridge University Press:  07 November 2014

Gabriele Sani ,
Giovanni Manfredi ,
Isabella Pacchiarotti ,
Saverio Simone Caltagirone ,
Iginia Mancinelli ,
Alexia E. Koukopoulos ,
Caterina Tatarelli ,
Giorgio D. Kotzalidis ,
Roberto Tatarelli  and
Paolo Girardi
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Abstract

Fever (pyretotherapy) was used for psychosis during the turn of the 19th century, but pyretotherapy (ie, the treatment of a disorder by inducing fever) fell out of use after the introduction of convulsive methods. Here, we report on a case of schizoaffective disorder and review classical and recent literature on fever and psychosis. The patient developed auditory hallucinations, persecutory delusional ideas, and was terrified soon upon his arrival in a foreign country. After being treated for 12 days with olanzapine and haloperidol, he developed a fever due to urinary infection; his creatine phosphokinase levels were high, prompting the suspension of antipsychotics. Psychotic symptom resolution followed immediately fever abatement. Antipsychotics were reintroduced at lower dosages. He was discharged asymptomatic with a prescription of olanzapine 15 mg/day and haloperidol 3 mg/day. The time course of symptom resolution in this patient suggests that fever had a beneficial role in this case. The associations between body temperature changes and psychotic symptoms need to be further studied.

Type
Case Report
Information
CNS Spectrums , Volume 12 , Issue 6 , June 2007 , pp. 447 - 450
Copyright
Copyright © Cambridge University Press 2007

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References

REFERENCES

1.Wagner-Jauregg, J. Über die Einwirkung fieberhafter Erkrankungen auf Psychosen. Jahbuch für Psychiatrie und Neurologie. 1887;7:94–131.Google Scholar
2.Wagner-Jauregg, J. Lebenserinnerungen. Schonbauer, L, Jantsch, M, eds. Vienna, Austria: Springer Verlag; 1950.Google Scholar
3.Whitrow, M. Wagner-Jauregg and fever therapy. Med Hist. 1990;34:294–310.CrossRefGoogle ScholarPubMed
4.Day, R, Nielsen, JA, Korten, A, et al.Stressful life events preceding the acute onset of schizophrenia: a cross-national study from the World Health Organization. Cult Med Psychiatry. 1987;11:123–205.CrossRefGoogle ScholarPubMed
5.Srikanth, S, Ravi, V, Poornima, KS, Shetty, KT, Gangadhar, BN, Janakiramaiah, N. Viral antibodies in recent onset, nonorganic psychoses: correspondence with symptomatic severity. Biol Psychiatry. 1994;36:517–521.CrossRefGoogle ScholarPubMed
6.Collins, PY, Wig, NN, Day, R, et al.Psychosocial and biological aspects of acute brief psychoses in three developing country sites. Psychiatr Q. 1996;67:177–193.CrossRefGoogle ScholarPubMed
7.Malhotra, S, Varma, VK, Misra, AK, Das, S, Wig, NN, Santosh, PJ. Onset of acute psychotic states in India: a study of sociodemographic, seasonal and biological factors. Acta Psychiatr Scand. 1998;97:125–131.CrossRefGoogle ScholarPubMed
8.Collins, PY, Varma, VK, Wig, NN, Mojtabai, R, Day, R, Susser, E. Fever and acute brief psychosis in urban and rural settings in north India. Br J Psychiatry. 1999;174:520–524.CrossRefGoogle Scholar
9.Farooq, S, Khawaja, MY. Fever and acute brief psychosis in developing countries. Br J Psychiatry. 1999;175:586.CrossRefGoogle ScholarPubMed
10.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Pscyhiatric Association; 1994.Google Scholar
11.Kapur, S, Arenovich, T, Agid, O, Zipursky, R, Lindborg, S, Jones, B. Evidence for onset of antipsychotic effects within the first 24 hours of treatment. Am J Psychiatry. 2005;162:939–946.CrossRefGoogle ScholarPubMed
12.Kapur, S, Agid, O, Mizrahi, R, Li, M. How antipsychotics work-from receptors to reality. NeuroRx. 2006;3:10–21.CrossRefGoogle ScholarPubMed
13.Agid, O, Seeman, P, Kapur, S. The “delayed onset” of antipsychotic action-an idea whose time has come and gone. J Psychiatry Neurosci. 2006;31:93–100.Google Scholar
14.Emsley, R, Rabinowitz, J, Medori, R. Time course for antipsychotic treatment response in first-episode schizophrenia. Am J Psychiatry. 2006;163:743–745.CrossRefGoogle ScholarPubMed
15.Sternbach, H, State, R. Antibiotics: neuropsychiatric effects and psychotropic interactions. Harv Rev Psychiatry. 1997;5:214–226.CrossRefGoogle ScholarPubMed
16.Marek, J. On the non specific antiinflammatory effects of other than antirheumatic drugs. Psychotropic drugs, inflammation and antiinflammatory drugs. Int J Tissue React. 1985;7:475–504.Google ScholarPubMed
17.Stevens, JR, Denney, D, Szot, P. Kindling with clozapine: behavioral and molecular consequences. Epilepsy Res. 1996;26:295–304.CrossRefGoogle ScholarPubMed
18.Overholser, W. Mental Hygiene. Proc Am Philosoph Soc. 1946;90:259–264.Google ScholarPubMed
19.Keck, PE Jr, Caroff, SN, McElroy, SL. Neuroleptic malignant syndrome and malignant hyperthermia: end of a controversy? J Neuropsychiatry Clin Neurosci. 1995;7:135–144.Google ScholarPubMed
20.Ford, DM, Klugman, KP. Contrasting roles of 5-hydroxytryptamine and noradrenaline in fever in rats. J Physiol. 1980;304:51–57.CrossRefGoogle ScholarPubMed
21.Bymaster, FP, Calligaro, DO, Falcone, JF, et al.Radioreceptor binding profile of the atypical antipsychotic olanzapine. Neuropsychopharmacology. 1996;14:87–96.CrossRefGoogle ScholarPubMed
22.Richelson, E, Souder, T. Binding of antipsychotic drugs to human brain receptors focus on newer generation compounds. Life Sci. 2000;68:29–39.CrossRefGoogle ScholarPubMed