A relatively normal 16-year-old Chinese woman with a six-month history of compulsive water drinking resulting in a comatose state is reported. The drinking was perpetuated by an enjoyable altered state of consciousness after ingestion of an average of 20 litres of water per day. Treatment by fluid restriction and, later, simple education was successful. The subjective dimension of an altered state of consciousness may provide an important explanation for the obscure aetiology.

A case of a psychotic illness following an induced termination of pregnancy is described; this is discussed in relation to the literature on the subject, and possible aetiological factors in the case are reviewed.

A patient is described who suffered from the neuroleptic malignant syndrome, complicated by a pneumomediastinum. This has not been reported previously.

This is the first report of a zuclopenthixol-induced NMS. The lack of previous reports may be because the receptor-binding profile of thioxanthenes gives rise to fewer extrapyramidal effects than comparable neuroleptics. It is important to know more of the relationship between the potential for induction of extrapyramidal effects and success in NMS rechallenge.