López Arteaga MT, Amo C, Sánchez Morla EM, Sánchez Román M. Induced psychosis after withdrawal of varenicline: a case report.

Objective: Varenicline has been associated with psychiatric side effects, and cases with psychotic symptoms during treatment have been reported, few of them after the withdrawal. We describe a case with no current or previous medical or psychiatric history.

Method: A single case report.

Results: The patient without previous psychiatric pathology, following the withdrawal of treatment with varenicline, experiences delirium and behavioural disturbances. There was a remission of symptoms after 3 weeks of treatment with risperidone.

Conclusion: Discontinuation of treatment with varenicline due to poor tolerance for side effects (nausea and insomnia) could trigger psychotic symptoms in subjects with no personal or family psychiatric history.

Caffeine remains the most widely used psychoactive drug and psychiatric populations tend to ingest more caffeine than the general community. It is important to assess caffeine intake in psychiatric patients as it may distort diagnostic signs and is known to interact with psychotropic medications. A blanket condemnation of caffeine use by psychiatric patients is, however, unwarrranted for while it may exacerbate some conditions (eg. anxiety disorders) it may prove beneficial to others (eg. schizophrenics) when used in moderate quantities. A scale for the estimation of caffeine intake is provided.